J Korean Orthop Assoc.  2007 Oct;42(5):623-629. 10.4055/jkoa.2007.42.5.623.

The Usefulness of Calcium Sulfate in Treatment of Benign Bone Tumor

• Jung ST
• Kim MS
• Jeong KC

• KMID: 2186469
• DOI: http://doi.org/10.4055/jkoa.2007.42.5.623

Abstract

PURPOSE: This study evaluated the results of the curettage and grafting of calcium sulfate for the treatment of a benign bone tumor to determine its efficacy as a bone graft substitute.
MATERIALS AND METHODS
Thirty six cases of calcium sulfate(Osteoset(R)) grafting for bone defect after curettage of benign bone tumor were evaluated. There were 21 males and 15 females with a mean age of 23 years (6-64). There were 23, 10 and 3 cases grafted with the Osteoset only, the Osteoset with allografts and the Osteoset with autografts, respectively. The average follow up duration was 19 months (12-49). The process of bone formation was observed and the times for graft absorption and complete bone formation were assessed. In addition, the time of bone formation was compared according to the patients' age, size of lesion, and grafting method, and the development of complications was observed.
RESULTS
Complete bone formation was observed in 34 (94.4%) out of 36 cases. The groups of younger patients, smaller size of lesion and grafting of Osteoset(R) only showed more rapid bone formation. However, there was no statistical significance. There was one case of soft tissue calcification observed.
CONCLUSION
Calcium sulfate is an effective substitute for an autogenous bone graft in the case of the treatment of a benign bone tumor, particularly in the case of an insufficient graft, such as in children and in those with a large bone defect. This method is a safe method that prevents complications in the donor site.

Keyword

Benign bone tumor; Calcium sulfate

MeSH Terms

Absorption
Allografts
Autografts
Calcium Sulfate*
Calcium*
Child
Curettage
Female
Follow-Up Studies
Humans
Male
Osteogenesis
Tissue Donors
Transplants
Calcium
Calcium Sulfate

Figure

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  Fig. 1 Pathologic fracture of the proximal femur associated with fibrous dysplasia in a 64-year-old female. (A) Preoperative plain radiograph shows a fracture of the proximal femur and radiolucent bone lesion at the fracture site. (B) Postoperative plain radiograph taken after plate fixation of the fracture and curettage and grafting of Osteoset® mixed with autograft. (C) Plain radiograph taken at 8 months after surgery shows bone union and complete healing of the previous bone lesion.

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  Fig. 2 Method for approximating the bone defect volume. Volume≒A×B×C.

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  Fig. 3 Aneurysmal bone cyst of the metacarpal bone in a 13-year-old boy. (A) Preoperative plain radiograph shows an expansile cystic lesion of the fourth metacarpal bone. (B) Postoperative radiograph taken after curettage and grafting of Osteoset®. (C) Plain radiograph taken at 4 weeks after surgery shows the complete resorption of Osteoset®. (D) Plain radiograph taken at 5 months after surgery shows complete bone healing.

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  Fig. 4 Simple bone cyst of proximal humerus in a 10-year-old girl. (A) Preoperative plain radiograph shows radiolucent cystic lesion in the proximal humerus. (B) Postoperative radiograph taken after curettage and grafting of Osteoset®. (C) At 6 weeks after surgery, calcium sulfate was almost resorbed. (D) Plain radiograph taken at 18 months after surgery show a remnant lesion at a more distal portion. (E) A second operation was performed with curettage of remnant lesions and the grafting of Osteoset®. (F) Plain radiograph taken at 6 months after the second operation shows complete bone healing without a remnant lesion.

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  Fig. 5 Soft tissue calcification after the grafting of calcium sulfate. (A) Plain radiograph taken after 1 month after grafting the Osteoset® shows soft tissue calcification around the lesion. (B) The consolidation of calcification is seen at the 16 months follow up.

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