Examination of X-ray bone density in patients with bone tumors using segmental bone aloimplants

Authors

  • Ya.O. Golovina State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • R.V. Malyk State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • M.Yu. Karpinsky State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine
  • O.D. Karpinska State Institution “Sytenko Institute of Spine and Joint Pathology of the National Academy of Medical Sciences of Ukraine”, Kharkiv, Ukraine

DOI:

https://doi.org/10.22141/1608-1706.1.23.2022.881

Keywords:

bone tumors, osteotomy, aloimplant, density

Abstract

Background. One of the complications of alloplasty is a violation of the processes of consolidation of the bone of the recipient and the aloimplant. This complication is affected by a number of factors: the quality of the aloimplant, the method of its sterilization, the methods of fixation in the bone of the recipient, and the algorithm of polychemotherapy after the intervention. The purpose was to study changes in bone density when using segmental bone alloplasty under different conditions in patients with tumors of long bones. Materials and methods. The radiographs of 13 patients after alloplasty of long bone defects with fixation with plates or blocking intramedullary rods using bone autografts were analyzed. The study was carried out immediately after the operation (I), after 1 month (II) and after 1 year (III). The optical density of the cortical layer was studied at 4 points: 1 — the recipient’s bone at 10 cm from the osteotomy zone, 2 — the recipient’s bone at 2 cm from the osteotomy zone, 3 — the contact zone of the bone aloimplant and the recipient’s bone, 4 — cortical. Results. At the І term, it was found that in patients with no fusion, the optical density of the contact zone was significantly (p = 0.044) less than in patients with normal consolidation. At the ІІ and ІІІ terms, the optical density of zone 3 in patients with fusion remained practically unchanged; with nonunion, this zone gradually gains density from 99 ± 18 units up to 172 ± 7 units. The optical density of the cortical layer of the bone at point 1 in patients with no consolidation of the contact zone decreases from 171 ± 11 units up to 163 ± 14 units (p = 0.042). In patients with normal union, the density in this zone remains the same within 200 units. The change in the optical density of the allograft bone tissue in patients of both subgroups increases with time, but in patients with fusion, this process occurs more rapidly. At term I, in patients who underwent fixation of the aloimplant with a rod, the optical density of the cortical layer of the bone at point 1 (164 ± 15 units) and at point 4 (148 ± 23 units) was less than in those who underwent fixation with a plate 250 ± 67 units and 176 ± 17 units, respectively. In patients who used fixation of the aloimplant with a plate at terms II and III, there was a decrease in the density of the cortical bone layer at 1 point to 202 ± 40 units, and an increase in optical density at point 4 to 205 ± 59 units. When examining at point 2, the optical density of bone tissue during fixation with a plate increases with time — from 184 ± 19 units up to 211 ± 48 units, in patients with rod fixation, the optical density at point 2 remains unchanged throughout the observation period. The optical density at point 3 after the operation during fixation with a plate was less (98 ± 46 units) than during fixation with a rod (121 ± 44 units). The optical density at point 3, when fixed with a plate, doubled in a year, and when fixed with a rod, the increase was much less. Conclusions. The absence of consolidation of the aloimplant and the bone of the recipient was observed only when using the plate fixation technique. The reduced optical density in the contact zone can be explained by the non-tight contact between the bone and the aloimplant, although the contact zone strengthens over time, the strength of the newly formed bone regenerate does not provide sufficient stability in this group of patients. With the use of an intramedullary locking nail, there were no signs of violation of the consolidation process, and the entire bone tissue acquired a greater density.

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Published

2022-05-16

How to Cite

Golovina, Y., Malyk, R., Karpinsky, M., & Karpinska, O. (2022). Examination of X-ray bone density in patients with bone tumors using segmental bone aloimplants. TRAUMA, 23(1), 43–50. https://doi.org/10.22141/1608-1706.1.23.2022.881

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Original Researches

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