Granular tricalcium phosphate grafting of cavitary lesions in human bone

Development of an effective and safe bone grafting substitute could potentially alleviate many of the problems associated with human bone graft materials. Reported here are the results of 18 patients who were treated with a ceramic bone graft substitute, tricalcium phosphate. Twenty cavitary defects were created by intralesional curettage of a variety of benign bone neoplasms. Following complete removal of the tumor, each defect was filled with tricalcium phosphate granules. All patients were followed with periodic clinical and radiologic examinations for a minimum of 2 years (average followup of 37 months; range, 24 to 66 months). The amount of graft resorption and new bone formation were separately assessed on a percentage basis. Judged by radiographic criteria, the tricalcium phosphate implant lost its postoperative granular pattern in advance of bony trabeculae formation. Radiographic healing of defects with normal appearing bone was complete in four patients by 12 months, in an additional eight patients by 24 months, and in all except four patients by 48 months. Healing was dependent upon defect size; the larger lesions healing more slowly. Clinical parameters of healing were seen in advance of complete bone remodeling and all patients, except one, had unrestricted activity by 24 months. No adverse reactions were attributed to the graft material.