Development of a bioactive implant for repair and potential healing of cranial defects

被引:48
作者
Engstrand, Thomas [1 ]
Kihlstrom, Lars [2 ]
Neovius, Erik [1 ]
Skogh, Ann-Charlott Docherty [1 ]
Lundgren, T. Kalle [1 ]
Jacobsson, Hans [3 ,4 ]
Bohlin, Jan [5 ]
Aberg, Jonas [6 ]
Engqvist, Hakan [6 ]
机构
[1] Karolinska Univ Hosp, Stockholm Craniofacial Ctr, Dept Mol Med & Surg, Plast Surg Sect, SE-17176 Stockholm, Sweden
[2] Karolinska Univ Hosp, Dept Clin Neurosci, Neurosurg Sect, SE-17176 Stockholm, Sweden
[3] Karolinska Univ Hosp, Dept Radiol & Nucl Med, SE-17176 Stockholm, Sweden
[4] Karolinska Inst, Stockholm, Sweden
[5] Uppsala Univ, Polymer Chem Sect, Dept Chem, Uppsala, Sweden
[6] Uppsala Univ, Appl Mat Sci Sect, Dept Engn Sci, Uppsala, Sweden
关键词
cranial implant; calcium phosphate; bone; regeneration; surgical technique; DECOMPRESSIVE CRANIECTOMY; BONE; CRANIOPLASTY; EXPERIENCE; STRENGTH;
D O I
10.3171/2013.6.JNS1360
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The repair of complex craniofacial bone defects is challenging and a successful result is dependent on the size of the defect, quality of the soft tissue covering the defect, and choice of reconstruction method. The objective of this study was to develop a bioactive cranial implant that could provide a permanent reconstructive solution to the patient by stimulating bone healing of the defect. In this paper the authors report on the feasibility and clinical results of using such a newly developed device for the repair of a large traumatic and therapy-resistant cranial bone defect. The patient had undergone numerous attempts at repair, in which established methods had been tried without success. A mosaic-designed device was manufactured and implanted, comprising interconnected ceramic tiles with a defined calcium phosphate composition. The clinical outcome 30 months after surgery revealed a restored cranial vault without postoperative complications. Computed tomography demonstrated signs of bone ingrowth. Examination with combined F-18-fluoride PET and CT provided further evidence of bone healing of the cranial defect.
引用
收藏
页码:273 / 277
页数:5
相关论文
共 24 条
[1]   Premixed Acidic Calcium Phosphate Cement: Characterization of Strength and Microstructure [J].
Aberg, J. ;
Brisby, H. ;
Henriksson, H. B. ;
Lindahl, A. ;
Thomsen, P. ;
Engqvist, H. .
JOURNAL OF BIOMEDICAL MATERIALS RESEARCH PART B-APPLIED BIOMATERIALS, 2010, 93B (02) :436-441
[2]   In vivo behavior of three different injectable hydraulic calcium phosphate cements [J].
Apelt, D ;
Theiss, F ;
El-Warrak, AO ;
Zlinszky, K ;
Bettschart-Wolfisberger, R ;
Bohner, M ;
Matter, S ;
Auer, JA ;
von Rechenberg, B .
BIOMATERIALS, 2004, 25 (7-8) :1439-1451
[3]   Long-term results following titanium cranioplasty of large skull defects [J].
Cabraja, Mario ;
Klein, Martin ;
Lehmann, Thomas-Nikolas .
NEUROSURGICAL FOCUS, 2009, 26 (06) :1-7
[4]   Clinical outcome of 285 Medpor grafts used for craniofacial reconstruction [J].
Cenzi, R ;
Farina, A ;
Zuccarino, L ;
Carinci, F .
JOURNAL OF CRANIOFACIAL SURGERY, 2005, 16 (04) :526-530
[5]   Bioceramics of calcium orthophosphates [J].
Dorozhkin, Sergey V. .
BIOMATERIALS, 2010, 31 (07) :1465-1485
[6]   Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases [J].
Gooch, M. Reid ;
Gin, Greg E. ;
Kenning, Tyler J. ;
German, John W. .
NEUROSURGICAL FOCUS, 2009, 26 (06) :1-7
[7]   Bioresorbability, porosity and mechanical strength of bone substitutes: What is optimal for bone regeneration? [J].
Hannink, Gerjon ;
Arts, J. J. Chris .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2011, 42 :S22-S25
[8]   Long-Term Complications of Decompressive Craniectomy for Head Injury [J].
Honeybul, Stephen ;
Ho, Kwok M. .
JOURNAL OF NEUROTRAUMA, 2011, 28 (06) :929-935
[9]   Observed versus Predicted Outcome for Decompressive Craniectomy: A Population-Based Study [J].
Honeybul, Stephen ;
Ho, Kwok M. ;
Lind, Christopher R. P. ;
Gillett, Grant R. .
JOURNAL OF NEUROTRAUMA, 2010, 27 (07) :1225-1232
[10]   Progressive Ankylosis Protein (ANK) in Osteoblasts and Osteoclasts Controls Bone Formation and Bone Remodeling [J].
Kim, Hyon Jong ;
Minashima, Takeshi ;
McCarthy, Edward F. ;
Winkles, Jeffrey A. ;
Kirsch, Thorsten .
JOURNAL OF BONE AND MINERAL RESEARCH, 2010, 25 (08) :1771-1783