Five years practical experience of using calcium phosphate bone graft substitute for reconstruction of bone defects in atypical cartilage tumors

In the surgical treatment of benign as well as low aggressive malignant (G1) bone tumors of small sizes, methods such as intralesional curettage, marginal resection, resection of part of the joint, or resection of the affected bone segment are used. In cases when intraosseous removal of the tumor is performed, there is a need for bone grafting of the defect, the purpose of which is to maintain and strengthen the structural strength of the bone, replace the volume of the bone defect, and accelerate the biological stimulation of bone tissue regeneration during fractures. The most widespread use of synthetic bone graft substitute based on calcium sulfate and calcium phosphate.

The study included 24 patients, 15 (62.5%) of whom were diagnosed with chondrosarcoma G1, 9 (37.5%) were diagnosed with enchondroma. For these patients, from 2015 to 2019 (52 months), surgical treatment was performed in the amount of curettage with replacement of the defect with the phosphate calcium bone graft substitute. In the studied group of patients, in 12 (50%) the tumor was localized in the femur, in 10 (41.7%) in the humerus, in the tibia and radius of the 1 patient, respectively. The mean follow-up period was 32 months and ranged from 7 to 52 months.

In the present study, during the observation period, none of the patients was diagnosed with local recurrence, distant metastasis, bone fracture, loss of bone graft substitute and infection. All patients showed satisfactory integration of tricalcium phosphate bone graft substitute. The average functional result after 6 months for the upper limb was 94%, for the lower limb 96%, according to the MSTS scale.

Replacing of the formed bone defects with a synthetic bone graft substitute containing tricalcium phosphate provides reliable, predictably fast kinetics of resorption and substitution.

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