[Metaphyseal defect substitute: hydroxylapatite ceramic. Results of a 3 to 4 year follow up]

45 trauma patients with fracture-related metaphyseal bone defects filled with hydroxyapatite ceramic (Endobon) were followed for three to four years after surgery. Osseointegration of Endobon could be confirmed histologically in all biopsates, which could be obtained during scheduled reintervention for hardware removal. The objective of clinical and radiological follow-up was to evaluate the extent of ceramic remodeling as well as long-term implant outcome. Thirteen patients undergoing surgery in 1992 or 1993 were available for follow-up. None of these patients showed radiologic evidence of loss of bony reconstruction or HAC sintering, nor was there evidence of HAC resorption or fragmentation. Our results--with respect to the examined few patients--suggest that Endobon is useful for filling bony defects in carefully selected trauma patients if certain surgical technique prerequisites are met. Like cancellous autografts special alloplasts appear to go some way toward solving problems of defect filling encountered in clinical practice.