The Journal of the Korean bone and joint tumor society
/
v.11
no.1
/
pp.62-70
/
2005
Purpose: We compared the time how much time spent until the bone unions, when we grafted fresh frozen allograft during therapy of benign bone tumor depends on the degrees of bony unions. Materials and Methods: This study selected 29 cases, in which a curettage on the benign bone tumors was conducted and a fresh frozen allograft was transplanted. The area of the focus, the new bone formation, the recurrence of the focus and complications in the plain radiographs were observed. Results: The average time when we could find out bony unions in the radiographs is eleven weeks. The time when we could observe the unions in the radiographs are 11.4 weeks in allograft group, 10.7 weeks in allograft and autograft groups and 13.6 weeks in allograft and bone substitute. On radiologic findings, the average lesion size is 40 cm3. The time when we could find bony unions are 9.3 weeks in less than 40 $cm^3$ and 12.9 weeks in more than 40 $cm^3$. We could observe recurrences in two cases. Conclusion: The authors could get the similar results between fresh frozen allograft, allograft and autograft after curettage of benign bone tumor. We can think the ideal method which is the transplantation of autograft, but if we can’t get autograft enough, the best way which heal the defects is the transplantation of fresh frozen allograft.
Kim, Jae-Do;Kim, Ji-Youn;Jang, Su-Jin;Chung, So-Hak;Jung, Gu-Hee
The Journal of the Korean bone and joint tumor society
/
v.16
no.1
/
pp.8-13
/
2010
Purpose: This study was performed to evaluate the effi ciency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. Materials and Methods: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. Results: The mean size of lesion was 33.5 $cm^3$ (range, 2.3-181.9 $cm^3$) (29.4 $cm^3$ in PRP group and 40.2 $cm^3$ in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. Conclusion: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.
Chun, Churl Hong;Lee, Byoung Chang;Kim, Young Jin;Yang, Hwan Duk
Journal of the Korean Arthroscopy Society
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v.3
no.2
/
pp.102-108
/
1999
Purpose : The purpose of this study was to evaluate the clinical results of bone-patellar tendon-bone(B-PTB) allograft for ACL reconstruction without mechanical tensioning device. Material and Method : Forty-six knees in 43 patients were reviewed and evaluated with subjective evaluation, objective evaluation, Telos stress arthrometer and modified Feagin Scoring System. The average age at the time of operation was 27 years(range, 18-42) and the average follow up period was 41 months(range, 22-79). Authors reconstructed ACL using B-PTB allograft which was prepared by rehydration preoperatively without tensioning by mechanical tensioning device. The tension for allograft was obtained by full flexion and extension intraoperatively. All operation were performed arthroscopically by two-tunnel method to avoid the mismatching of allograft tendon length. Result : The modified Feagin Scoring System revealed 39 cases(84.7%) with excellent or good results and 7 cases(15.3%) with fair or poor results. The mean follow-up Lysholm Knee Score was 84. Telos arthrometer revealed 41 cases had an injured-to-uninjured difference of 5 mm or less(mean 2.3mm). The range of motion of knee was nearly normal and there was no extension lag in any cases at last follow up. Conclusion : Clinical results using B-PTB allograft showed less morbidity than B-PTB autograft. The intraoperative tensioning method by full flexion and extension without mechanical tensioning device was not bad. Therefore, B-PTB allograft is a good substitute material in reconstruction of the ACL.
Purpose : The purpose of this study was to compare the efficacy of bone-patellar tendon-bone(B-PTB) allograft with autograft B-PTB reconstruction of anterior cruciate ligament(ACL) according to the subjective and objective criteria. Materials and Methods : 42 patients were treated for acute rupture or chronic insufficiency of the ACL between March 1993 and June 1996. There were 18 autografts and 24 allografts for ACL reconstruction. At 2 years of follow-up after operation, autograft and allograft groups were compared based on subjective, objective criteria and Telos stress arthrometer. Results : The modified Feagin Scoring System revealed 16 patients$(88.9\%)$ with a satisfactory result by autografts, but 21 patients$(87.5\%)$ with a satisfactory result by allografts after 2-years follow-lip. There was no statistically significant difference between the two groups. ACL reconstruction with B-PTB allograft did not produce a significant functional deficit. But patellofemoral pain and crepitus were more frequent in the autografts$(33.3\%)$ than allografts$(8.3\%)$ (p<0.05). Conclusion : The ACL deficient knees treated with allografts for ACL reconstruction tended to be better than those reconstructed with autografts fur the reduction of patellofemoral crepitus and pain. B-PTB allograft provides an acceptable alternative to autograft tissue for reconstruction of the ACL.
The Journal of the Korean bone and joint tumor society
/
v.20
no.2
/
pp.74-79
/
2014
Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.
This study has been performed to evaluate the relationship between the remained mineral components in a decalcified bone matrix and an ectopic bone formation efficiency. The freezed rat diaphyseal cortical bones measuring 0.5cm in length were demineralized in heated 0.6N HCl at $60^{\circ}C$ for 5, 10, 15, 20, 25, 30, 35, 40 minutes, respectively, using a controlled heat ultrasonic cleaner. Each 1cc of decalcifying solution taken during decalcification procedure was used to calculate calcium content using calcium dignostics kit under 600nm of spectrophotomer. After decalcification, each specimen was also weighed. Then each prepared specimen was implanted into the dorsal pouch of 24 Sprague-Dawley rats divided into 8 groups by time course. The implants were harvested at 1, 2, and 3 weeks and prepared for routine H-E stain specimens to evaluate osteogenic activity. The results are as follows: 1. There was statistical significant difference in change of calcium concentration up to demineralization of 30 minutes and each allogenic bones decalcifed up to 20 minutes revealed 99.65% of decalcification in average. 2. There was statistical significant difference in change of weight in demineralized allogenic bone up to 20 minutes treatment but, no significant change was noted after that time. 3. The histologic analysis revealed active ectopic bone formation in the implanted allografts demineralized for 20, 25, 30 minutes, respectively. However, the other groups of allografts showed relatively poor osteoinductive activity. These findings suggest that complete decalcification with a minimized degeneration of collagen matrix is necessary to induce maximal osteogenesis by decalcified bone allograft.
This study was aimed to suggest to better treatment method of jaw cyst that the maximum diameter was wider than 3cm, using different treatment and clinical and radiographic result. We divided the 60 patients into three groups, group A(20 patients) were treated with cyst enucleation and Decalcified Freeze-Dried Allogeneic Bone(DFDB) graft, group B(20 patients) were treated with cyst enucleation and autogenous bone graft, group C(20 patients) were treated with only cyst enucleation. Each group was evaluated with panoramic radiograph and clinical sign & symptom at pre-op and post-op(immediate, 6, 12, 24, 36 month). Bone density was evaluated with disital densitometer. The result was as follows : 1. Post-Op infection was higher in group C(4 pts.) than in group A(1 pt.) and B(1 pt.) 2. Post-Op gingival recession was higher in group C(3 Pts.) than in group A(1 pt.) and B(1 pt.) 3. Anatomic distortion was higher in group C(3 Pt.) than in group A(1 Pt.), and B(1 pt.) 4. Reoperation was done in two patients who were in group C 5. There were donor site morbidity in two patients 6. There was no significant difference between group A and B in their bony density in their follow up period(p>0.05). 7. There were significant differences between group A, B and group C in their bony density until post-op 24 months but a little differences at post-op 36 months(P<0.01)
The Journal of the Korean bone and joint tumor society
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v.12
no.2
/
pp.165-170
/
2006
We reported a case of chondrosarcoma in proximal tibia in a 44-year-old man. MR images demonstrated a $3.5{\times}20$ cm sized bone tumor. In reconstruction of resected proximal tibia, we used the allograft bone and soft tissue defects were covered by medial gastrocnemius rotation flap and skin graft. There were no local recurrence and distant metastasis and any complication such as secondary infection, nonunion, metal failure at the time of the last follow-up. There was no limitation of knee motion through the appropriate rehabilitaion programs.
The Journal of the Korean bone and joint tumor society
/
v.17
no.2
/
pp.73-78
/
2011
Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.
Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
Journal of the Korean Orthopaedic Association
/
v.56
no.1
/
pp.42-50
/
2021
Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.
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