Journal of Orthopedics and Joint Surgery

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VOLUME 6 , ISSUE 1 ( January-June, 2024 ) > List of Articles

CASE SERIES

Effect of Synthetic Bone Graft Substitutes in Management of Nonunion in Long Bones: A Case Series

Muthamilselvan Kumanan, Manikandan Navaneethakrishnapandian, Mohamed Ibrahim

Keywords : Case report, Bone graft substitutes, Calcium sulfate, Calcium triphosphate, Synthetic bone graft substitutes

Citation Information : Kumanan M, Navaneethakrishnapandian M, Ibrahim M. Effect of Synthetic Bone Graft Substitutes in Management of Nonunion in Long Bones: A Case Series. 2024; 6 (1):39-43.

DOI: 10.5005/jojs-10079-1130

License: CC BY-NC 4.0

Published Online: 12-01-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Introduction: Treating nonunion is a major concern for any orthopedic surgeon. Preparation of autograft for use in nonunion itself is associated with various complications, starting from donor site morbidities to postoperative wound infections. To overcome these complications, an artificial substance that is biocompatible, which mimics all the properties of an autograft, may be an ideal thing for the management of nonunion. One such thing that was put forth in our study is ”Synthetic Bone Graft.” All the pros and cons and their effectiveness in today's modern orthopedic management of nonunion are discussed below. Aim: To evaluate the efficacy and outcome of synthetic bone grafting substances in the management of nonunion in long bones. Materials and methods: This is a cross-sectional study. Patients with noninfected nonunion are selected. A total of 20 patients were treated with specific fracture fixation augmented with synthetic bone grafts and were followed for about 18 months in the Department of Orthopaedics, Tirunelveli Medical College Hospital, Tirunelveli, Tamil Nadu, India. Results and discussion: In our study of 20 cases with nonunion of long bones, 90% of cases (18 cases out of 20 cases) showed clinical and radiological union among our case study. A bone substitute with the composition of tricalcium phosphate and calcium sulfate is used in our study. Functional and radiological outcomes of synthetic bone graft materials in the management of nonunion in long bones showed far better results compared to other bone graft materials. In the future, the use of these synthetic bone graft materials in bone regeneration under specific indications and with safety roles will simulate the normal bone formation cascade with reduced morbidity and cost in the long-term.


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  1. Childs Nurse SG. Stimulators of bone healing. Biologic and biomechanical. Orthop Nurse 2003;22(6):421–428. DOI: 10.1097/00006416-200311000-00010
  2. Jones AL, Bucholz RW, Bosse MJ, et al. Recombinant human BMP-2 and allograft compared with autogenous bone graft for reconstruction of diaphyseal tibial fractures with cortical defects. A randomized, controlled trial. J Bone Joint Surg Am 2006;88(7):1431–1441. DOI: 10.2106/JBJS.E.00381
  3. Janicki P, Schmidmaier G. What should be the characteristics of the ideal bone graft substitute? Combining scaffolds with growth factors and/or stem cells. Injury 2011;42(Suppl 2):S77–S81. DOI: 10.1016/j.injury.2011.06.014
  4. Campana V, Milano G, Pagano E, et al. Bone substitutes in orthopaedic surgery: from basic science to clinical practice. J Mater Sci Mater Med 2014;25(10):2445–2461. DOI: 10.1007/s10856-014-5240-2
  5. Rupp M, Biehl C, Budak M, et al. Diaphyseal long bone nonunions - types, aetiology, economics, and treatment recommendations. Int Orthop 2018;42(2):247–258. DOI: 10.1007/s00264-017-3734-5
  6. Baldwin P, Li DJ, Auston DA, et al. Autograft, allograft, and bone graft substitutes: clinical evidence and indications for use in the setting of orthopaedic trauma surgery. J Orthop Trauma 2019;33(4):203–213. DOI: 10.1097/BOT.0000000000001420
  7. Finkemeier CG. Bone-grafting and bone-graft substitutes. J Bone Joint Surg Am 2002;84(3):454–464. DOI: 10.2106/00004623-200203000-00020
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