Numerous bone graft substitutes are available as alternatives to autologous and allograft bone grafts. The use of ultraporous beta-tricalcium phosphate for cavitary bone defects in our institution was based on the hypothesis that it would have gradual but complete incorporation over several months, similar to the smooth transition seen in animal models. This retrospective, uncontrolled study reviews 24 patients who had bone grafting of a cavitary defect with ultraporous beta-tricalcium phosphate mixed with local blood. Radiographically, resorption and trabeculation increased steadily with time, with trabeculation lagging slightly behind resorption. Resorption and trabeculation were more advanced at times beyond 6 weeks in small defects (< 43 cm) compared with large defects (>/= 43 cm). The presence of peripheral radiolucency seen early around nearly all grafts disappeared in small lesions by 1 year, but still was visible in larger lesions at the latest followup. Bone renewal seems to correspond temporally with gradual replacement of graft material, but incorporation is not complete even at 1 year in large defects. Clinically, there is a low rate of complications associated with the use of ultraporous beta-tricalcium phosphate, and patients progressed to unrestricted activities of daily living and recreational activities within 3 months.
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Introduction: Synthetic bone graft materials are commonly used to fill defects after curettage of benign bone lesions. Ultraporous beta tricalcium phosphate (TCP) is a popular synthetic compound used in this situation. Prior clinical studies based on plain X-ray analysis suggest incorporation of TCP is incomplete, even when combined with bone marrow (BMA).
View Article and Find Full Text PDFComparative Study on the Application of Mesenchymal Stromal Cells Combined with Tricalcium Phosphate Scaffold into Femoral Bone Defects.
Cell Transplant
October 2018
7 Department of Oncology and Radiotherapy, Charles University, Faculty of Medicine Hradec Králové, Czech Republic.
This prospective study sought to evaluate the healing quality of implanted ultraporous β-tricalcium phosphate sown with expanded autologous mesenchymal stromal cells (MSCs) into femoral defects during revision hip arthroplasty. A total of 37 osseous defects in 37 patients were treated and evaluated concerning bone regeneration. Nineteen subjects received β-tricalcium phosphate graft material serving as a carrier of expanded autologous MSCs (the trial group A), nine subjects received β-tricalcium phosphate graft material only (the study group B) and nine subjects received cancellous allografts only (the control group C).
View Article and Find Full Text PDFUtilizing Autologous Multipotent Mesenchymal Stromal Cells and β-Tricalcium Phosphate Scaffold in Human Bone Defects: A Prospective, Controlled Feasibility Trial.
Biomed Res Int
January 2017
Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Vídeňská 1083, 142 20 Prague, Czech Republic; Department of Neuroscience, 2nd Faculty of Medicine, Charles University in Prague, V Úvalu 84, 150 06 Prague, Czech Republic.
The purpose of this prospective controlled study was to compare healing quality following the implantation of ultraporous β-tricalcium phosphate, containing either expanded autologous mesenchymal stromal cells (trial group, 9 patients) or β-tricalcium phosphate alone (control group, 9 patients), into femoral defects during revision total hip arthroplasty. Both groups were assessed using the Harris Hip Score, radiography, and DEXA scanning at 6 weeks and 3, 6, and 12 months postoperatively. A significant difference in the bone defect healing was observed between both groups of patients (P < 0.
View Article and Find Full Text PDFUltraporous β-tricalcium phosphate alone or combined with bone marrow aspirate for benign cavitary lesions: comparison in a prospective randomized clinical trial.
J Bone Joint Surg Am
January 2013
Department of Orthopedic Surgery, SUNY Upstate Medical University, 6620 Fly Road, East Syracuse, NY 13057, USA.
Background: Ultraporous β-tricalcium phosphate (TCP) synthetic graft material (Vitoss; Orthovita) persists for a year or longer in some cases. In this study, we prospectively examined healing of cavitary defects filled with TCP versus TCP and bone marrow aspirate (TCP/BM) with the hypothesis that bone-marrow aspirate speeds incorporation of bone graft substitute.
Methods: Fifty-five patients with a benign bone lesion undergoing surgical curettage were randomized to receive TCP (N = 26; mean duration of follow-up [and standard deviation], 20.
Effectiveness of ultraporous β-tricalcium phosphate (vitoss) as bone graft substitute for cavitary defects in benign and low-grade malignant bone tumors.
Am J Orthop (Belle Mead NJ)
January 2012
Department of Orthopaedics, Ohio State University Medical Center, Columbus, Ohio 43210-1280, USA.
We retrospectively evaluated healing with ultraporous β-tricalcium phosphate (β-TCP [Vitoss; Orthovida, Malvern, Pennsylvania]) bone graft in patients who underwent surgical excision or curettage of benign bone lesions subsequently filled with bone void filler. Twentynine patients were treated with curettage and ultraporous β-TCP morsels. Radiologic defect size at initial postoperative presentation and subsequent visits (minimum follow-up, 6 months) was evaluated.
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