• Title/Summary/Keyword: 동종골

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The Treatment of the Benign Bone Tumor by Curettage and Fresh Frozen Allograft (양성 골 종양의 절제 및 소파술 후 사용한 신선 동결 동종골 이식의 결과)

  • Jung, Sung-Taek;Bae, Bong-Hyun;Lim, Keun-Young;Kong, Il-Kyu
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.62-70
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    • 2005
  • Purpose: We compared the time how much time spent until the bone unions, when we grafted fresh frozen allograft during therapy of benign bone tumor depends on the degrees of bony unions. Materials and Methods: This study selected 29 cases, in which a curettage on the benign bone tumors was conducted and a fresh frozen allograft was transplanted. The area of the focus, the new bone formation, the recurrence of the focus and complications in the plain radiographs were observed. Results: The average time when we could find out bony unions in the radiographs is eleven weeks. The time when we could observe the unions in the radiographs are 11.4 weeks in allograft group, 10.7 weeks in allograft and autograft groups and 13.6 weeks in allograft and bone substitute. On radiologic findings, the average lesion size is 40 cm3. The time when we could find bony unions are 9.3 weeks in less than 40 $cm^3$ and 12.9 weeks in more than 40 $cm^3$. We could observe recurrences in two cases. Conclusion: The authors could get the similar results between fresh frozen allograft, allograft and autograft after curettage of benign bone tumor. We can think the ideal method which is the transplantation of autograft, but if we can’t get autograft enough, the best way which heal the defects is the transplantation of fresh frozen allograft.

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The Effect of Platelet-Rich Plasma on Allograft Transplantation after Curettage in Benign Bone Tumor (양성 골 종양의 소파술 후 실시한 동종골 이식에서 혈소판 풍부 혈장 투여의 효과)

  • Kim, Jae-Do;Kim, Ji-Youn;Jang, Su-Jin;Chung, So-Hak;Jung, Gu-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.8-13
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    • 2010
  • Purpose: This study was performed to evaluate the effi ciency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. Materials and Methods: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. Results: The mean size of lesion was 33.5 $cm^3$ (range, 2.3-181.9 $cm^3$) (29.4 $cm^3$ in PRP group and 40.2 $cm^3$ in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. Conclusion: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.

How to Overcome Complications of Allograft Transplantation? (골종양 절제 후 동종골을 이용한 재건술의 합병증 및 해결방법)

  • Cho, Yool;Choi, Young;Kwon, Young-Ho;Chung, So-Hak;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.65-72
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    • 2011
  • Purpose: We evaluated the complications of allograft reconstruction after a bone tumor resection, and reviewed literatures to overcome such complications. Materials and Methods: We retrospectively reviewed clinical records and radiographs of fifteen patients in whom reconstruction with allograft after bone tumor resection. Results: Eight patients were men and seven were women with a mean age of 27.1 years (1-56 years) and a mean follow-up period of 89.5 months (33-165 months). All postoperative complications related to the allograft were recorded. Twenty patients (80.0%) obtained a radiologic bony union at a mean of 8.35 months (4-12 months). The mean Musculoskeletal Tumor Society score was 73.5% (46.6-93.0%). Nine patients (60.0%) experienced one event and 3 (20.0%) patients experienced multiple events during the follow-up period. Recorded events were infection (3), fracture (2), nonunion (2), limb length discrepancy (2) and varus deformity (2). The mean event free survival period was 60.8 months (6-144 months). The mean allograft survival period was 80.2 months and the 5 year survival rate of the allografts was 83.0%. Conclusion: In order to overcome complications, the combination of an allograft and vascularized fibular graft is highly recommended. In the near future, the tissue engineering technique, the application of the stem cell and PRP, could reduce the complication of allograft such as resorption and nonunion.

The Result of Bone Grafting for Fibrous Dysplasia (섬유성 골 이형성증에서 시행한 골 이식술의 결과 분석)

  • Jeong, Won-Ju;Kim, Tae-Seong;Cho, Hwan-Seong;Yoon, Jong-Pil;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.74-79
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    • 2014
  • Purpose: Fibrous dysplasia is related to the mutation of gene encoding the alpha-subunit of a signal-transducing G-protein and has variable clinical course. Operation can be performed to prevent functional disorder or structural deformity. After curettage, autologous bone graft were used to fill the defects after curettage. The aim of this study is to compare the result of autogenous cancellous bone grafting and allogenic bone grafting for fibrous dysplasia. Materials and Methods: Among the patients who visit our hospital during the period of April, 1997 to October, 2013, we selected 34 patients who diagnosed fibrous dysplasia and visited our clinic over 1 year. There were 13 males and 21 females. Average age was 26.4 (range 2 to 57) years old. Autogenous bone graft (group I) in 5 cases, Non-autogenous bone graft (group II) in 30 cases. Iliac bone is used in all cases of autogenous bone graft. There were no significant difference in age, follow-up period, preoperational laboratory finding between two groups. Radiographic image was done to evaluate the recurrence of fibrous dysplasia or secondary degeneration. Results: There were four cases in recurrence (group I: 1 case, group II: 3 cases, p=0.554). In all recurrent cases, reoperations were done using curettage and autogenous iliac bone graft. There was no re-recurrence after reoperation. One case of secondary aneurysmal bone cyst was confirmed (group II) and 1 cases of pathologic fractures had developed (group I: 0 case, group II: 1 cases, p=0.559). No malignant change occurred. Conclusion: There were no significant difference between autogenous bone graft group and non-autogenous bone graft group. Our result suggested that autogenous bone graft seems to be good method to treat fibrous dysplasia, in the case of small volume of tumor lesion or non-weight bearing portion.

Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Reconstruction of Anterior Cruciate Ligament With Bone-Patellar tendon-Bone Allograft (동종 슬개건을 이용한 전방십자인대 재건술)

  • Chun, Churl Hong;Lee, Byoung Chang;Kim, Young Jin;Yang, Hwan Duk
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.102-108
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    • 1999
  • Purpose : The purpose of this study was to evaluate the clinical results of bone-patellar tendon-bone(B-PTB) allograft for ACL reconstruction without mechanical tensioning device. Material and Method : Forty-six knees in 43 patients were reviewed and evaluated with subjective evaluation, objective evaluation, Telos stress arthrometer and modified Feagin Scoring System. The average age at the time of operation was 27 years(range, 18-42) and the average follow up period was 41 months(range, 22-79). Authors reconstructed ACL using B-PTB allograft which was prepared by rehydration preoperatively without tensioning by mechanical tensioning device. The tension for allograft was obtained by full flexion and extension intraoperatively. All operation were performed arthroscopically by two-tunnel method to avoid the mismatching of allograft tendon length. Result : The modified Feagin Scoring System revealed 39 cases(84.7%) with excellent or good results and 7 cases(15.3%) with fair or poor results. The mean follow-up Lysholm Knee Score was 84. Telos arthrometer revealed 41 cases had an injured-to-uninjured difference of 5 mm or less(mean 2.3mm). The range of motion of knee was nearly normal and there was no extension lag in any cases at last follow up. Conclusion : Clinical results using B-PTB allograft showed less morbidity than B-PTB autograft. The intraoperative tensioning method by full flexion and extension without mechanical tensioning device was not bad. Therefore, B-PTB allograft is a good substitute material in reconstruction of the ACL.

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EFFECT OF DECALCIFIED FREEZE-DRIED ALLOGENEIC BONE GRAFT(DFDB) ON THE JAW DEFECTS AFTER CYST ENUCLEATION (낭종 적출후 악골 결손부 치유에 관한 동종골 이식 효과에 관한 연구)

  • Lee, Dong-Keun;Min, Seung-Ki;Kwon, Kyung-Hwan;Sung, Hun-Mo;Park, Hwa-Kyu;Kang, Mun-Jeong;Sin, Ki-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.360-365
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    • 1999
  • This study was aimed to suggest to better treatment method of jaw cyst that the maximum diameter was wider than 3cm, using different treatment and clinical and radiographic result. We divided the 60 patients into three groups, group A(20 patients) were treated with cyst enucleation and Decalcified Freeze-Dried Allogeneic Bone(DFDB) graft, group B(20 patients) were treated with cyst enucleation and autogenous bone graft, group C(20 patients) were treated with only cyst enucleation. Each group was evaluated with panoramic radiograph and clinical sign & symptom at pre-op and post-op(immediate, 6, 12, 24, 36 month). Bone density was evaluated with disital densitometer. The result was as follows : 1. Post-Op infection was higher in group C(4 pts.) than in group A(1 pt.) and B(1 pt.) 2. Post-Op gingival recession was higher in group C(3 Pts.) than in group A(1 pt.) and B(1 pt.) 3. Anatomic distortion was higher in group C(3 Pt.) than in group A(1 Pt.), and B(1 pt.) 4. Reoperation was done in two patients who were in group C 5. There were donor site morbidity in two patients 6. There was no significant difference between group A and B in their bony density in their follow up period(p>0.05). 7. There were significant differences between group A, B and group C in their bony density until post-op 24 months but a little differences at post-op 36 months(P<0.01)

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Comparison of Gap Pressure in Opening Wedge High Tibial Osteotomy versus Compressive Strength of Allogenous Wedge Bone Blocks (경골 근위부 개방 절골술 시 개방부 압력과 동종 쐐기 골편의 최대압축하중 비교)

  • Yoon, Kyoung Ho;Kim, Jung Suk;Kwon, Yoo Beom;Kim, Eung Ju;Lee, Myeong-Kyu;Kim, Sang-Gyun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.127-134
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    • 2020
  • Purpose: The aims of this study were (1) to investigate the relationship between the characteristics of allogenic bone block and the compressive strength of an allogenic bone block measured by biomechanical experiments, and (2) to compare the maximum pressure load of allogenic bone block with the gap pressure measured at the high tibial opening osteotomy. Materials and Methods: Ten patients who provided informed consent for gap pressure measurements during opening wedge high tibial osteotomy (OWHTO) were included. The gap pressures were measured at 1 mm intervals while opening the osteotomy site from 8 mm to 14 mm. Seventeen U-shaped allogenous wedge bone blocks were made from the femur, tibia, and humerus. The height, width, cross-sectional area, and cortex thickness of the bone blocks were measured, along with the maximum compressive load just before breakage. The relationship between these characteristics and the maximum pressure load of the bone blocks was evaluated. The gap pressures measured in OWHTO were compared with the maximum pressure loads of the allogenous wedge bone blocks to evaluate the possibility of inserting allogenous wedge bone blocks into the osteotomy site without a distractor in OWHTO. Results: The OWHTO gap pressure increased with increasing osteotomy site opening. The mean gap pressure, which occurred at a 14-mm opening, was 282±93 N; the maximum pressure was 427 N. The maximum pressure load of the allografts was 13,379±6,469 N (minimum, 5,868; maximum, 29,130 N) and was correlated significantly with the cortical bone thickness (correlation coefficient=0.693, p=0.002) and cross-sectional area (correlation coefficient=0.826, p<0.001). Depending on the sterilization method, the maximum pressure loads for the bone blocks were 13,406±5,928 N for freeze-dried and 13,348±7,449 N for fresh frozen. The maximum compressive load of the allogenous wedge bone blocks was 13.7-times greater than that in OWHTO opened to 14 mm (5,868 N vs. 427 N). Conclusion: The compressive strength of allogenous wedge bone blocks was sufficiently greater than the gap pressure in OWHTO. Therefore, allogenous wedge bone blocks can be inserted safely into the osteotomy site without a distractor.