Eur J Pediatr Surg 2012; 22(02): 143-147
DOI: 10.1055/s-0032-1308699
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment of Benign Bone Defects in Children with Silicate-Substituted Calcium Phosphate (SiCaP)

Hans Joachim Kirschner
1   Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Tuebingen, Germany
,
Florian Obermayr
1   Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Tuebingen, Germany
,
Juergen Schaefer
2   Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
,
Justus Lieber
1   Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Tuebingen, Germany
› Author Affiliations
Further Information

Publication History

07 October 2011

15 October 2011

Publication Date:
19 April 2012 (online)

Abstract

Background In children with benign bone defects, various treatment options are recommended. Whether these defects should be curetted, osteosynthetically stabilized and/or filled with allogenic or synthetic bone material is still a matter of controversy.

Methods The reported study presents preliminary results of five children with benign bone lesions of the lower extremity. Curettage and filling of the defect with a commercially available silicate-substituted calcium phosphate (SiCaP) (Actifuse® by ApaTech Ltd., Elstree, United Kingdom) was performed. Patients were followed-up in the outpatient clinic. The healing process was assessed according to the clinical and radiological criteria.

Results Clinical and radiological follow-up showed uneventful healing without intraoperative and short-term complications. All patients were capable of full weight bearing after a few weeks and currently did not experience any decreased range of movement among adjacent joints. Growth disturbances did not occur. In all patients increasing cancellous bone reconstruction of the defect, without signs of osteolysis could be shown radiologically.

Conclusion SiCaP represents a good and safe alternative to hitherto existing therapies in the management of defined symptomatic benign bone defects in the pediatric age group.

 
  • References

  • 1 Lee RS, Weitzel S, Eastwood DM , et al. Osteofibrous dysplasia of the tibia. Is there a need for a radical surgical approach?. J Bone Joint Surg Br 2006; 88 (5) 658-664
  • 2 Szendroi M, Antal I, Arató G. Adamantinoma of long bones: a long-term follow-up study of 11 cases. Pathol Oncol Res 2009; 15 (2) 209-216
  • 3 Mankin HJ, Trahan CA, Fondren G, Mankin CJ. Non-ossifying fibroma, fibrous cortical defect and Jaffe-Campanacci syndrome: a biologic and clinical review. Chir Organi Mov 2009; 93 (1) 1-7
  • 4 Cottalorda J, Bourelle S. Current treatments of primary aneurysmal bone cysts. J Pediatr Orthop B 2006; 15 (3) 155-167
  • 5 Moore TM, Harvey Jr JP. The management of benign bone lesions. West J Med 1976; 124 (2) 92-98
  • 6 Hass HJ, Krause H, Kroker S, Wagemann W, Meyer F. Bone formation using human demineralised bone matrix (Grafton) for the treatment of bone cysts in children. Eur J Pediatr Surg 2007; 17 (1) 45-49
  • 7 Joeris A, Ondrus S, Planka L, Gal P, Slongo T. ChronOS inject in children with benign bone lesions—does it increase the healing rate?. Eur J Pediatr Surg 2010; 20 (1) 24-28
  • 8 Spies CK, Schnürer S, Gotterbarm T, Breusch S. The efficacy of Biobon and Ostim within metaphyseal defects using the Göttinger Minipig. Arch Orthop Trauma Surg 2009; 129 (7) 979-988
  • 9 Hardenbrook MA, Lombardo SR. Silicate-substituted calcium phosphate as a bone void filler after kyphoplasty in a young patient with multiple compression fractures due to osteogenesis imperfecta variant: case report. Neurosurg Focus 2006; 21 (6) E9
  • 10 Lodwick GS, Wilson AJ, Farrell C, Virtama P, Smeltzer FM, Dittrich F. Estimating rate of growth in bone lesions: observer performance and error. Radiology 1980; 134 (3) 585-590
  • 11 Nair MB, Varma H, Shenoy SJ, John A. Treatment of goat femur segmental defects with silica-coated hydroxyapatite—one-year follow-up. Tissue Eng Part A 2010; 16 (2) 385-391
  • 12 Hing KA, Revell PA, Smith N, Buckland T. Effect of silicon level on rate, quality and progression of bone healing within silicate-substituted porous hydroxyapatite scaffolds. Biomaterials 2006; 27 (29) 5014-5026
  • 13 Ortiz EJ, Isler MH, Navia JE, Canosa R. Pathologic fractures in children. Clin Orthop Relat Res 2005; (432) 116-126
  • 14 Moreau G, Letts M. Unicameral bone cyst of the calcaneus in children. J Pediatr Orthop 1994; 14 (1) 101-104
  • 15 Hunt KJ, Bergeson A, Coffin CM, Randall RL. Percutaneous curettage and bone grafting for humeral simple bone cysts. Orthopedics 2009; 32 (2) 89
  • 16 Thawrani D, Thai CC, Welch RD, Copley L, Johnston CE. Successful treatment of unicameral bone cyst by single percutaneous injection of alpha-BSM. J Pediatr Orthop 2009; 29 (5) 511-517
  • 17 Knorr P, Schmittenbecher PP, Dietz HG. Elastic stable intramedullary nailing for the treatment of complicated juvenile bone cysts of the humerus. Eur J Pediatr Surg 2003; 13 (1) 44-49
  • 18 Park YK, Unni KK, McLeod RA, Pritchard DJ. Osteofibrous dysplasia: clinicopathologic study of 80 cases. Hum Pathol 1993; 24 (12) 1339-1347
  • 19 Ozaki T, Hamada M, Sugihara S, Kunisada T, Mitani S, Inoue H. Treatment outcome of osteofibrous dysplasia. J Pediatr Orthop B 1998; 7 (3) 199-202
  • 20 Kempson RL. Ossifying fibroma of the long bones. A light and electron microscopic study. Arch Pathol 1966; 82 (3) 218-233
  • 21 Betsy M, Kupersmith LM, Springfield DS. Metaphyseal fibrous defects. J Am Acad Orthop Surg 2004; 12 (2) 89-95
  • 22 Spies CK, Schnürer S, Gotterbarm T, Breusch S. The efficacy of Biobon and Ostim within metaphyseal defects using the Göttinger Minipig. Arch Orthop Trauma Surg 2009; 129 (7) 979-988
  • 23 Cottalorda J, Bourelle S. Modern concepts of primary aneurysmal bone cyst. Arch Orthop Trauma Surg 2007; 127 (2) 105-114
  • 24 Topouchian V, Mazda K, Hamze B, Laredo JD, Penneçot GF. Aneurysmal bone cysts in children: complications of fibrosing agent injection. Radiology 2004; 232 (2) 522-526
  • 25 Cottalorda J, Kohler R, Chotel F , et al. Recurrence of aneurysmal bone cysts in young children: a multicentre study. J Pediatr Orthop B 2005; 14 (3) 212-218
  • 26 Hing KA, Wilson LF, Buckland T. Comparative performance of three ceramic bone graft substitutes. Spine J 2007; 7 (4) 475-490