Radiological and histological analysis of synthetic bone grafts in recurring giant cell tumour of bone: a retrospective study.

Abstract

PURPOSE: To review the radiology and histology of synthetic bone grafts resected from patients with recurrent giant cell tumour (GCT) of bone. METHODS: 22 patients underwent curettage and grafting for GCT of bone using autogenous cancellous bone mixed with apatite-wollastonite-containing glass ceramic (AWGC), hydroxyapatite (HA), or a mixture of HA and tricalcium phosphate (TCP). Patients were followed up every 3 to 6 months. Three men and 3 women aged 20 to 33 (mean, 27) years developed local recurrence. The mean interval from surgery to recurrence was 35 (range, 12-89) months. Specimens containing the recurring GCT of bone and the surrounding synthetic bone and new bone were evaluated. RESULTS: No complication related to the use of the synthetic bone (such as toxicity, fracture or deformity) occurred. The synthetic bone incorporated well into the surrounding host bone, but was not completely absorbed. HA was more bioactive than AWGC in human bone. HA/TCP were more bioresorbable and osteoconductive in human bone than HA or AWGC. In most areas of AWGC grafts, intervening layers of fibrous connective tissue were seen between the granules and the bone. In most areas of HA grafts, the granules were completely surrounded by viable bone, with bone ingrowth into the pores of the granules, as well as venules and fibrous tissue ingrowth in the pores of portions of the grafts. CONCLUSION: A mixture of synthetic bone and autogenous cancellous bone is safe and useful for grafting after curettage for GCT of bone.