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Patient-Specific Titanium-Reinforced Calcium Phosphate Implant for the Repair and Healing of Complex Cranial Defects
Karolinska Univ Hosp, Dept Neurosurg, Clin Neurosci, Stockholm, Sweden;Karolinska Inst, Stockholm, Sweden.
Karolinska Inst, Div Imaging & Technol, Dept Clin Sci Intervent & Technol, Huddinge, Sweden.
Karolinska Inst, Stockholm, Sweden;Karolinska Univ Hosp, Dept Mol Med & Surg, Unit Craniofacial Dis, Stockholm, Sweden.
Karolinska Univ Hosp, Dept Clin Pathol, Stockholm, Sweden.
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2019 (English)In: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 122, p. E399-E407Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The reconstruction of complex cranial defects is challenging and is associated with a high complication rate. The development of a patient-specific, titanium-reinforced, calcium phosphate-based (CaP-Ti) implant with bone regenerative properties has previously been described in 2 case studies with the hypothesis that the implant may improve clinical outcome. OBJECTIVE: To identify whether the introduction of CaP-Ti implant has the potential to improve clinical outcome. METHODS: A retrospective review of all patients having undergone CaP-Ti cranioplasty was conducted. Comprehensive clinical data were collected from the hospital computer database and patient records. Bone formation and osseointegration were analyzed in a single retrieval specimen. RESULTS: Fifty patients, with 52 cranial defects, met the inclusion criteria. The patient cohort displayed a previous failure rate of 64% (32/50) with autologous bone, alloplastic materials, or both. At a median follow-up time of 25 months, the explantation rate due to either early postoperative infection or persistent wound dehiscence was 1.9% (1/53) or 3.8% (2/53), respectively. Surgical intervention with local wound revision was required in 2 patients without the need of implant removal. One patient had a brain tumor recurrence, and the implant was explanted 31 months after implantation. Histologic examination showed that the entire implant was partly yet evenly transformed into vascularized compact bone. CONCLUSION: In the present study the CaP-Ti implant appears to have improved the clinical outcomes in a cohort of patients with a high rate of previous cranioplasty failures. The bone regenerative effect may in particular have an impact on the long-term success rate of the implant.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2019. Vol. 122, p. E399-E407
Keywords [en]
3-Dimensional, Bone regeneration, Calcium phosphate, Ceramic, Cranial, Cranioplasty
National Category
Medical Materials Surgery
Identifiers
URN: urn:nbn:se:uu:diva-377212DOI: 10.1016/j.wneu.2018.10.061ISI: 000457328100047PubMedID: 30342265OAI: oai:DiVA.org:uu-377212DiVA, id: diva2:1291462
Funder
EU, Horizon 2020, El 9741Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-02-25Bibliographically approved

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