Long-term results from use of pasteurized bone
Long-term results from use of pasteurized bone
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DOI：
10.1007/s00776-012-0258-0
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发表时间：
2012-09-01
影响因子：
1.7
通讯作者：
Kawaguchi, Noriyoshi
中科院分区：
文献类型：
--
作者：
Koyanagi, Hirotaka;Matsumoto, Seiichi;Kawaguchi, Noriyoshi
巴氏灭菌骨（PB）是再生骨。巴氏灭菌法具有杀死肿瘤细胞的效果，同时保持初始强度。然而，很少有报告已发表的长期过程中，因此，在这项研究中，我们评估了长期的过程中使用的PB和检查适当的重建methods.We审查了27例重建手术使用PB之间进行1990年和2002年。其中，我们排除了12例致死性病例和1例停止随访的病例。因此，我们的最终分析包括14例病例，平均随访时间为165个月。重建方法：骨关节移植6例，人工关节复合移植3例，中间移植1例，骨盆骨移植4例，其中7例骨移植成活。PB的5年和10年生存率分别为78.6%和47.6%。6例骨关节病例中有3例因迟发性吸收或PB感染而失败。对于复合移植物或中间移植物的患者，当使用少量PB时，可以实现长期生存。对于骨盆移植物的患者，在P1骨盆的病例中实现了长期存活，但是在小骨结合表面上的大PB移植物在长期内不成功。在这些结果的基础上，我们能够实现成功的长期结果与小PB移植物上大的骨交界面。为了防止骨吸收，实现长期生存的PB，重要的是使用一个小的PB移植物，并创造一个大的表面积的接触正常骨。这些因素有利于PB的存活和获得肢体功能。
Pasteurized bone (PB) is recycled bone. The pasteurization has a tumor cell-killing effect wit retention of initial strength. However, few reports have been published on its long-term course; thus, in this study, we evaluated the long-term course of use of PB and examined appropriate reconstruction methods.We reviewed 27 cases in which reconstructive surgery using PB was performed between 1990 and 2002. Of these, we excluded 12 fatal cases and 1 case in which follow-up was discontinued. Therefore, our final analysis consisted of 14 cases with an average follow-up period of 165 months. The reconstruction methods used were: osteoarticular graft in 6 cases, composite graft with prosthesis in 3 cases, intercalary graft in 1 case, and reconstruction using PB from the pelvis in 4 cases.The PB survived in 7 of the 14 cases. Five and 10-year survival of the PB was 78.6 and 47.6 %, respectively. Three of the 6 osteoarticular cases failed because of late-onset absorption or infection of the PB. For patients with composite graft or intercalary graft, long-term survival was achieved when small amounts of PB were used. For patients with pelvic grafts, long-term survival was achieved in a case of P1 pelvis, but large PB grafts on small bone-junction surfaces were not successful in the long term. On the basis of these results, we were able to achieve successful long-term results with small PB grafts on large bone-junction surfaces.To prevent bone absorption and achieve long-term survival of PB, it is important to use a small PB graft and create a large surface area of contact with normal bone. These factors are advantageous to PB survival and to gaining limb function.