Paediatric cranial defect reconstruction using bioactive fibre-reinforced composite implant: early outcomes

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• 作者：Jaakko M. Piitulainen ; Jussi P. Posti ; Kalle M. J. Aitasalo…
• 关键词：Cranioplasty ; Craniectomy ; Craniofacial bone reconstruction ; Fibre ; reinforced composite ; FRC ; Bioactive glass ; Paediatric ; Skull bone defect
• 刊名：Acta Neurochirurgica
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：157
• 期：4
• 页码：681-687
• 全文大小：486 KB
• 参考文献：1. Aitasalo, KM, Piitulainen, JM, Rekola, J, Vallittu, PK (2014) Craniofacial bone reconstruction with bioactive fiber-reinforced composite implant. Head Neck 36: pp. 722-728 CrossRef
  2. Ballo, AM, Akca, EA, Ozen, T, Lassila, L, Vallittu, PK, N?rhi, TO (2009) Bone tissue responses to glass fiber-reinforced composite implants–a histomorphometric study. Clin Oral Implants Res 20: pp. 608-615
  3. Bowers, CA, Riva-Cambrin, J, Hertzler, DA, Walker, ML (2013) Risk factors and rates of bone flap resorption in pediatric patients after decompressive craniectomy for traumatic brain injury. J Neurosurg Pediatr 11: pp. 526-532 CrossRef
  4. Bonis, P, Frassanito, P, Mangiola, A, Nucci, CG, Anile, C, Pompucci, A (2012) Cranial repair: how complicated is filling a “hole-. J Neurotrauma 29: pp. 1071-1076 CrossRef
  5. DeLuca, L, Raszewski, R, Tresser, N, Guyuron, B (1997) The fate of preserved autogenous bone graft. Plast Reconstr Surg 99: pp. 1324-1328 CrossRef
  6. Drago, L, Romano, D, Vecchi, E, Vassena, C, Logoluso, N, Mattina, R, Romano, CL (2013) Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitro and prospective clinical study. BMC Infect Dis 13: pp. 584 CrossRef
  7. Dünisch, P, Walter, J, Sakr, Y, Kalff, R, Waschke, A, Ewald, C (2013) Risk factors of aseptic bone resorption: a study after autologous bone flap reinsertion due to decompressive craniotomy. J Neurosurg 118: pp. 1141-1147 CrossRef
  8. Engstrand, T, Kihlstr?m, L, Neovius, E, Skogh, AC, Lundgren, TK, Jacobsson, H, Bohlin, J, Aberg, J, Engqvist, H (2014) Development of a bioactive implant for repair and potential healing of cranial defects. J Neurosurg 120: pp. 273-277 CrossRef
  9. Frassanito, P, Massimi, L, Caldarelli, M, Tamburrini, G, Rocco, C (2012) Complications of delayed cranial repair after decompressive craniectomy in children less than 1?year old. Acta Neurochir (Wien) 154: pp. 927-933 CrossRef
  10. Frassanito, P, Massimi, L, Caldarelli, M, Tamburrini, G, Rocco, C (2014) Bone flap resorption in infants. J Neurosurg Pediatr 13: pp. 243-244 CrossRef
  11. Goldstein, JA, Paliga, JT, Bartlett, SP (2013) Cranioplasty: indications and advances. Curr Opin Otolaryngol Head Neck Surg 21: pp. 400-409 CrossRef
  12. Grant, GA, Jolley, M, Ellenbogen, RG, Roberts, TS, Gruss, JR, Loeser, JD (2004) Failure of autologous bone-assisted cranioplasty following decompressive craniectomy in children and adolescents. J Neurosurg 100: pp. 163-168
  13. Güresir, E, Schuss, P, Vatter, H, Raabe, A, Seifert, V, Beck, J (2009) Decompressive craniectomy in subarachnoid hemorrhage. Neurosurg Focus 26: pp. E4 CrossRef
  14. Hench, LL, Paschall, HA (1973) Direct chemical bond of bioactive glass-ceramic materials to bone and muscle. J Biomed Mater Res 7: pp. 25-42 CrossRef
  15. Horan, TC, Andrus, M, Dudeck, MA (2008) CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 36: pp. 309-332 CrossRef
  16. Hulbert, SF, Young, FA, Mathews, RS, Klawitter, JJ, Talbert, CD, Stelling, FH (1970) Potential of ceramic materials as permanently implantable skeletal prostheses. J Biomed Mater Res 4: pp. 433-456 CrossRef <
• 刊物主题：Neurosurgery; Interventional Radiology; Neuroradiology; Neurology; Surgical Orthopedics; Minimally Invasive Surgery;
• 出版者：Springer Vienna
• ISSN：0942-0940

文摘

Background In children, approximately half of cryopreserved allograft bone flaps fail due to infection and resorption. Synthetic materials offer a solution for allograft bone flap resorption. Fibre-reinforced composite with a bioactive glass particulate filling is a new synthetic material for bone reconstruction. Bioactive glass is capable of chemically bonding with bone and is osteoinductive, osteoconductive and bacteriostatic. Fibre-reinforced composite allows for fabricating thin (0.8?mm) margins for implant, which are designed as onlays on the existing bone. Bioactive glass is dissolved over time, whereas the fibre-reinforced composite serves as a biostable part of the implant, and these have been tested in preclinical and adult clinical trials. In this study, we tested the safety and other required properties of this composite material in large skull bone reconstruction with children. Method Eight cranioplasties were performed on seven patients, aged 2.5-6?years and having large (>16?cm2) skull bone defects. The implant used in this study was a patient-specific, glass-fibre-reinforced composite, which contained a bioactive glass particulate compound, S53P4. Results During follow-up (average 35.1?months), one minor complication was observed and three patients needed revision surgery. Two surgical site infections were observed. After treatment of complications, a good functional and cosmetic outcome was observed in all patients. The implants had an onlay design and fitted the defect well. In clinical and imaging examinations, the implants were in the original position with no signs of implant migration, degradation or mechanical breakage. Conclusions Here, we found that early cranioplasty outcomes with the fibre-reinforced composite implant were promising. However, a longer follow-up time and a larger group of patients are needed to draw firmer conclusions regarding the long-term benefits of the proposed novel biomaterial and implant design. The glass-fibre-reinforced composite implant incorporated by particles of bioactive glass may offer an original, non-metallic and bioactive alternative for reconstruction of large skull bone defects in a paediatric population.