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Allograft versus bioactive glass (BG-S53P4) in pediatric benign bone lesions : a randomized clinical trial |
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| Author: | Syvänen, Johanna1; Serlo, Willy2; Jalkanen, Jenni3; |
| Organizations: |
1Department of Paediatric Surgery and Orthopaedics, University of Turku and Turku University Hospital, Turku, Finland 2Department of Children and Adolescents, Oulu University Hospital and PEDEGO research unit Oulu University and MRC Oulu, Oulu Finland 3Department of Paediatric Surgery and Orthopaedics, University of Kuopio and Kuopio University Hospital, Kuopio, Finland
4Medical Imaging Centre of Southwest Finland, Turku University Hospital, Turku, Finland
5Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland |
| Format: | article |
| Version: | accepted version |
| Access: | embargoed |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe20231020140746 |
| Language: | English |
| Published: |
Journal of Bone and Joint Surgery,
2023
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| Publish Date: | 2024-01-19 |
| Description: |
AbstractBackground: Benign bone cysts in children have a high risk of recurrence after bone grafting. The optimal treatment and filling material for these lesions are currently unknown. Methods: We compared cyst recurrence after intralesional curettage and filling with allograft versus bioactive glass (BG-S53P4; Bonalive) in a randomized clinical trial. The volume of recurrent cyst at 2-year follow-up was the primary outcome. Results: Of 64 eligible children, 51 (mean age, 11.1 years) were randomized to undergo filling of the cyst using morselized allograft (26) or bioactive glass (25). Twelve (46%) of the children in the allograft group and 10 (40%) in the bioactive glass group developed a recurrence (odds ratio [OR] for bioactive glass = 0.79, 95% confidence interval [CI] = 0.25 to 2.56, p = 0.77). The size of the recurrent cyst did not differ between the allograft group (mean, 3.3 mL; range, 0 to 13.2 mL) and the bioactive glass group (mean, 2.2 mL; range, 0 to 16.6 mL, p = 0.43). After adjusting for the type of lesion (aneurysmal bone cyst versus other), bioactive glass also did not prevent larger (>1 mL) recurrent cysts (adjusted OR = 0.42, 95% CI = 0.13 to 1.40, p = 0.16). The Musculoskeletal Tumor Society score improved significantly (p ≤ 0.013) from preoperatively to the 2-year follow-up in both groups (to 28.7 for bioactive glass and 29.1 for bone graft). Four (15%) of the children in the allograft group and 6 (24%) in the bioactive glass group required a reoperation during the follow-up (OR for bioactive glass = 1.74, 95% CI = 0.43 to 7.09, p = 0.50). Conclusions: Filling with bioactive glass and with allograft in the treatment of benign bone lesions provided comparable results in terms of recurrence and complications. see all
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| Series: |
Journal of bone & joint surgery |
| ISSN: | 0021-9355 |
| ISSN-E: | 1535-1386 |
| ISSN-L: | 0021-9355 |
| Volume: | 105 |
| Issue: | 9 |
| Pages: | 659 - 666 |
| DOI: | 10.2106/JBJS.22.00716 |
| OADOI: | https://oadoi.org/10.2106/JBJS.22.00716 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3126 Surgery, anesthesiology, intensive care, radiology |
| Subjects: | |
| Funding: |
This study was supported by foundations, national state research funding, and a grant from industry to the Research Institute of Helsinki University Hospital. The funding was used only for researchers’ salaries, and the funders had no role in the analyses or writing of the manuscript. |
| Copyright information: |
© 2023 by The Journal of Bone and Joint Surgery, Incorporated. This is a non-final version of an article published in final form in Syvänen, Johanna MD, PhD; Serlo, Willy MD, PhD; Jalkanen, Jenni MD, PhD; Kohonen, Ia MD, PhD; Raitio, Arimatias MD, PhD; Nietosvaara, Yrjänä MD, PhD; Helenius, Ilkka MD, PhD. Allograft Versus Bioactive Glass (BG-S53P4) in Pediatric Benign Bone Lesions: A Randomized Clinical Trial. The Journal of Bone and Joint Surgery 105(9):p 659-666, May 3, 2023. | DOI: 10.2106/JBJS.22.00716. |