Patient-Specific Titanium-Reinforced Calcium Phosphate Implant for the Repair and Healing of Complex Cranial Defects
| Autor: | Christopher Illies, Thomas Engstrand, Kalle Conneryd Lundgren, Lars Kihlström Burenstam Linder, Ulrik Birgersson |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Calcium Phosphates Male medicine.medical_specialty Adolescent Medical Materials medicine.medical_treatment Brain tumor Cranial Medicinska material och protesteknik Osseointegration Cranioplasty Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Precision Medicine Bone regeneration Aged Retrospective Studies Aged 80 and over Titanium Wound Healing Wound dehiscence business.industry Kirurgi Skull Prostheses and Implants Middle Aged Plastic Surgery Procedures Patient specific Ceramic medicine.disease Surgery Calcium phosphate 030220 oncology & carcinogenesis Cohort Female Neurology (clinical) Implant 3-Dimensional business Craniotomy 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | World Neurosurgery. 122:e399-e407 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2018.10.061 |
| Popis: | Background The reconstruction of complex cranial defects is challenging and is associated with a high complication rate. The development of a patient-specific, titanium-reinforced, calcium phosphate–based (CaP-Ti) implant with bone regenerative properties has previously been described in 2 case studies with the hypothesis that the implant may improve clinical outcome. Objective To identify whether the introduction of CaP-Ti implant has the potential to improve clinical outcome. Methods A retrospective review of all patients having undergone CaP-Ti cranioplasty was conducted. Comprehensive clinical data were collected from the hospital computer database and patient records. Bone formation and osseointegration were analyzed in a single retrieval specimen. Results Fifty patients, with 52 cranial defects, met the inclusion criteria. The patient cohort displayed a previous failure rate of 64% (32/50) with autologous bone, alloplastic materials, or both. At a median follow-up time of 25 months, the explantation rate due to either early postoperative infection or persistent wound dehiscence was 1.9% (1/53) or 3.8% (2/53), respectively. Surgical intervention with local wound revision was required in 2 patients without the need of implant removal. One patient had a brain tumor recurrence, and the implant was explanted 31 months after implantation. Histologic examination showed that the entire implant was partly yet evenly transformed into vascularized compact bone. Conclusion In the present study the CaP-Ti implant appears to have improved the clinical outcomes in a cohort of patients with a high rate of previous cranioplasty failures. The bone regenerative effect may in particular have an impact on the long-term success rate of the implant. |
| Databáze: | OpenAIRE |
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