Clinical experience with a macroporous synthetic bone substitute (Eurocer®) in the treatment of the patients with bone defects

Abstract

The treatment of bone defects was a major challenge and may still be a problem today. Due to the disadvantages with biologically bone grafts there is a high clinical demand for synthetic bone substitution materials. The aim of this prospective study is to reveal biocompatibility integration and extension of osseous healing for a biphasic synthetic ceramic bone substitute (Eurocer), when used in the treatment of 31patients with 33 bone defects (fractures, nonunions, os-teoarthritis). Eurocer® (FH Orthopaedics France) is an osteoconductive ceramic material representing a mixture of 55% hydroxyapatite and 45% tricalcium-phosphate and is available in granular form and in various geometric shapes. The authors used GESTO (Greffes et Substitutes Tissulaires en Orthope-die) protocol for preoperative selection and postoperative follow-up. The mean defect volume for all defects treated with Eurocer was 12cc. According to the size and type of defects the authors used Eurocer® as a single component or mixed with autologous bone graft. Stabilization was achieved by internal fixation in all operation except one (a fracture of humeral head). We have used for osteosynthesis classic plates or plates with angular stability, especially in compression fractures associated with osteoporosis. All patients have been followed-up clinically and radiologic for 2, 3, 4, 6, 9, 12 and 18 months post-operative. The mean time to clinically healing was 3.2 months while the mean time to radiographic healing was 4.5 months. We observed no implant fragmentation and no local inflammation or sepsis. Due to minimally invasive surgery and fast rehabilitation, no joint stiffness or limited joint motion was recorded. This prospective study demonstrates that the biphasic synthetic ceramic material Eurocer® is an effective bone graft substitute for usage in patients with bone defects. To insure a consistent result it is mandatory to strictly follow the three requirements for osteoconduction: proximity, viability and stability.