Skip Navigation LinksHome > January 2014 - Volume 34 - Issue 1 > Results of Cement versus Bone Graft Reconstruction after Int...
Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e31829b2f61
Tumors

Results of Cement versus Bone Graft Reconstruction after Intralesional Curettage of Bone Tumors in the Skeletally Immature Patient

Wallace, Matthew T. MD, MBA*; Henshaw, Robert M. MD

Collapse Box

Abstract

Background:

Resection of periphyseal tumors in children presents several unique challenges and complications. Injury to the adjacent physis during resection and adjuvant application has been associated with adverse growth-related outcomes including angular deformities and physeal arrest. The appropriate method of reconstructing bone defects after resection is also controversial. To date there is scant literature on the use of polymethylmethacrylate (PMMA) bone cement as a method of reconstruction in children, and few long-term studies exist on the incidence of growth-related complications after reconstruction. The objective of this study is to evaluate the mechanical, oncological, and developmental outcomes of PMMA use in children.

Methods:

The authors retrospectively reviewed the medical records and radiographs of 36 skeletally immature patients who underwent intralesional resections of locally aggressive bone tumors. These patients were divided into 17 patients who received reconstruction with PMMA cement, and 19 patients who were reconstructed with bone graft. Follow-up clinical and radiographic evaluations performed after skeletal maturity were reviewed to assess the structural durability, local tumor recurrence rates, reoperation rates, and the incidence of postoperative complications such as deformity, adjacent joint arthrosis, growth arrest, pain, and functional limitation.

Results:

The average patient age at the time of surgery was 11.79 years (range, 6 to 15 y). The average length of patient follow-up was 5.3 years (range, 2 to 11.5 y). There were no statistically significant differences observed in the rates of reoperation, local tumor recurrence, growth-related complications, adjacent joint arthrosis, or postoperative pain between the 2 groups. There were no postoperative fractures in the cement group, compared to 3 fractures in the bone graft group, although this was not statistically significant.

Conclusions:

PMMA cement as a structural augment after resection may be used in the pediatric population for improving the mechanical stability of bone. Cement use is associated with complication rates of arthrosis, local recurrence, and growth complications comparable to those observed with bone grafting.

Level of Evidence:

Level III: Retrospective comparison study.

Copyright © 2013 by Lippincott Williams & Wilkins

The Pediatric Orthopaedic Society of North America (POSNA)
is a group of healthcare professionals, primarily pediatric orthopaedic surgeons, dedicated to advancing musculoskeletal care of children and adolescents. JPO is our official member journal. 
Like us on facebook and become a member today!

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.