Abstract
The purpose of this study was to review the outcomes of patients treated with injectable calcium phosphate cement (Norian SRS, Norian Corporation, Cupertino, California) for contained bone defects after resection of benign or low-grade malignant bone tumours.
The clinical records and radiographs of 17 patients who had been treated with calcium phosphate cement were reviewed, looking for incorporation into bone, reabsorption of the material and complications.
The 17 patients had a mean age of 29.8 years (range 7 to 64). The diagnosis was giant cell tumour in 9 cases, fibrous dyplasia in 2, low grade chondrosarcoma in 2, and one each of enchondroma, chondromyxoid fibroma, osteofibrous dysplasia, and chondroblastoma. The tibia was involved in 9 cases, the femur in 6 and the radius in 2. The mean follow up was 11 months (range 3 to 25).
The material is radioopaque and well visualised on plain radiographs. In most cases, incorporation of the material into the bone structure appeared good, but there was little absorption of the material during the followup available. The exceptions were 2 cases in which the material was absorbed following local recurrence of giant cell tumour.
One fracture associated with a giant cell tumour healed well in the presence of the material. In three patients, there were clinical and radiological features at follow up suggestive of periostitis related to the material. In one case a florid effusion of the knee may have been due to the material.
Injectable calcium phosphate cement may have a role in the management of contained defects requiring mechanical support following resection of benign or low-grade malignant tumours of bone. However, problems with periostitis, possibly synovitis and absorption in the presence of local recurrence should be considered.
The abstracts were prepared by Mr Roger Tillman. Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN
