Journal of IMAB
Publisher: Peytchinski Publishing Ltd.
ISSN:
1312-773X (Online)
Issue:
2024, vol. 30, issue3
Subject Area:
Medicine
-
DOI:
10.5272/jimab.2024303.5673
Published online: 02 August 2024
Case report
J of IMAB. 2024 Jul-Sep;30(3):5673-5679
CALCANEAL RECONSTRUCTION WITH A LARGE BONY DEFECT WITH THE AID OF BIOACTIVE GLASS – CASE STUDY
Emil Simeonov


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Department of Orthopedics and Traumatology, Faculty of Medicine, Medical University – Pleven, Bulgaria.
ABSTRACT:
Bone defect reconstruction is a critical component of orthopedic surgery, aiming to restore bones' structural integrity and functionality after injury. Recent developments in biomedical technology have brought forward several advancements in this field, particularly in the development and application of bone graft substitutes.
These materials are engineered to mimic the biological and mechanical properties of the bone, thereby facilitating new bone growth and integration without the limitations and morbidity associated with traditional bone grafts.
Bioactive glass is an example of such innovation in bone graft substitutes. Composed primarily of silicon dioxide, along with calcium oxide and phosphate, it is designed to undergo a chain of reactions to form a layer of hydroxyapatite that is chemically and structurally similar to human bone.
Bioactive glass (BAG) has already found its place in maxilla-facial and spine surgery. However, it is surprising that limited data exist on the use of BAG in trauma patients.
We present a case of a 42-year-old male who arrived at the emergency department following a high-energy trauma to the calcaneus after a fall from 4-5 meters onto his left foot. CT imaging revealed a bone deficit in the affected calcaneus due to the impact trauma. The patient underwent open reduction and internal fixation (ORIF) with bioactive glass (BAG), which was used as an alternative to traditional bone grafting.
Keywords: Bone grafts and substitutes, bioglass, calcaneus fracture,
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Please cite this article as: Simeonov E. Calcaneal reconstruction with a large bony defect with the aid of bioactive glass – case study. J of IMAB. 2024 Jul-Sep;30(3):5673-5679. [Crossref - 10.5272/jimab.2024303.5673]
Correspondence to: Dr. Emil Simeonov, MD, PhD, Clinic of Orthopaedics & Traumatology, UMBAL "Dr. Georgi Stranski "- Pleven; 89, Ruse Str., Pleven 5803, Bulgaria; E-mail: emil.simeonov.pl@gmail.com
REFERENCES:
1. Georgeanu VA, Gingu O, Antoniac IV, Manolea HO. Current Options and Future Perspectives on Bone Graft and Biomaterials Substitutes for Bone Repair, from Clinical Needs to Advanced Biomaterials Research. Appl Sci. 2023; 13(14):8471. [Crossref]
2. Fernandez de Grado G, Keller L, Idoux-Gillet Y, Wagner Q, Musset AM, Benkirane-Jessel N, et al. Bone substitutes: a review of their characteristics, clinical use, and perspectives for large bone defects management. J Tissue Eng. 2018 Jun 4;9:2041731418776819. [PubMed]
3. Raghuram A, Singh A, Chang DK, Nunez M, Reece EM. Bone Grafts, Bone Substitutes, and Orthobiologics: Applications in Plastic Surgery. Semin Plast Surg. 2019 Aug;33(3):190-199. [PubMed]
4. Greenspan D. Bioglass at 50 – A look at Larry Hench's legacy and bioactive materials. Biomed Glasses. 2019 Jan;5(1):178-184. [Crossref]
5. Geurts JAP, van Vugt TAG, Arts JJC. Use of contemporary biomaterials in chronic osteomyelitis treatment: Clinical lessons learned and literature review. J Orthop Res. 2021 Feb;39(2):258-264. [PubMed]
6. Van Vugt TAG, Geurts JAP, Blokhuis TJ. Treatment of infected tibial non-unions using a BMAC and S53P4 BAG combination for reconstruction of segmental bone defects: A clinical case series. Injury. 2021 Jun;52 Suppl 2:S67-S71. [PubMed]
7. Heikkilä JT, Kukkonen J, Aho AJ, Moisander S, Kyyrönen T, Mattila K. Bioactive glass granules: a suitable bone substitute material in the operative treatment of depressed lateral tibial plateau fractures: a prospective, randomized 1 year follow-up study. J Mater Sci Mater Med. 2011 Apr;22(4):1073-80. [PubMed]
8. Galluzzo M, Greco F, Pietragalla M, De Renzis A, Carbone M, Zappia M, et al. Calcaneal fractures: radiological and CT evaluation and classification systems. Acta Biomed. 2018 Jan 19;89(1-S):138-150. [PubMed]
9. Chirayath A, Dhaniwala N, Kawde K. A Comprehensive Review on Managing Fracture Calcaneum by Surgical and Non-surgical Modalities. Cureus. 2024 Feb 23;16(2):e54786. [PubMed]
10. Xue N, Ding X, Huang R, Jiang R, Huang H, Pan X, et al. Bone Tissue Engineering in the Treatment of Bone Defects. Pharmaceuticals. 2022 Jul 17;15(7):879. [Crossref]
11. Gillman CE, Jayasuriya AC. FDA-approved bone grafts and bone graft substitute devices in bone regeneration. Mater Sci Eng C Mater Biol Appl. 2021 Nov; 130;112466. [PubMed]
12. Wang W, Yeung KWK. Bone grafts and biomaterials substitutes for bone defect repair: A review. Bioact Mater. 2017 Jun 7;2(4):224-247. [PubMed]
13. Shanmuganantha L, Khan MUA, Sulong AB, Ramli MI, Baharudin A, Ariffin HM, et al. Characterization of titanium ceramic composite for bone implants applications. Ceram Int. 2022 Aug 15;48(16):22808-19. [Crossref]
14. Schmalz G, Hickel R, Price RB, Platt JA. Bioactivity of Dental Restorative Materials: FDI Policy Statement. Int Dent J. 2023 Feb;73(1):21-27. [PubMed]
15. Hench LL. The story of Bioglass. J Mater Sci Mater Med. 2006 Nov;17(11):967-78. [PubMed]
16. Jones JR. Reprint of: Review of bioactive glass: From Hench to hybrids. Acta Biomater. 2015 Sep;23 Suppl:S53-82. [PubMed]
17. Hupa L. 1-Composition-property relations of bioactive silicate glasses. In: Bioactive Glasses : Materials, Properties and Applications, 2nd ed. Ylänen H, editor. Woodhead Publishing Series in Biomaterials. 2018. p. 1-35. [Crossref]
18. Tsigkou O, Jones JR, Polak JM, Stevens MM. Differentiation of fetal osteoblasts and formation of mineralized bone nodules by 45S5 Bioglass® conditioned medium in the absence of osteogenic supplements. Biomaterials. 2009 Jul;30(21):3542-50. [PubMed]
19. Wang Y, Liao T, Shi M, Liu C, Chen X. Facile synthesis and in vitro bioactivity of radial mesoporous bioactive glasses. Mater Lett. 2017 Nov 1;206:205-209. [Crossref]
20. Schmidt AH. Autologous bone graft: Is it still the gold standard? Injury. 2021 Jun;52 Suppl 2:S18-S22. [PubMed]
21. Ilharreborde B, Morel E, Fitoussi F, Presedo A, Souchet P, Penneçot GF, et al. Bioactive glass as a bone substitute for spinal fusion in adolescent idiopathic scoliosis: a comparative study with iliac crest autograft. J Pediatr Orthop. 2008 Apr-May;28(3):347-51. [PubMed]
22. Swan MC, Goodacre TE. Morbidity at the iliac crest donor site following bone grafting of the cleft alveolus. Br J Oral Maxillofac Surg. 2006 Apr;44(2):129-33. [PubMed]
23. Hernigou J, Picard L, Alves A, Silvera J, Homma Y, Hernigou P. Understanding bone safety zones during bone marrow aspiration from the iliac crest: the sector rule. Int Orthop (SICOT). 2014 Nov;38(11):2377-84. [Crossref]
24. Jessop ZM, Al-Himdani S, Clement M, Whitaker IS. The Challenge for Reconstructive Surgeons in the Twenty-First Century: Manufacturing Tissue-Engineered Solutions. Front Surg. 2015 Oct 16;2:52. [PubMed]
25. Brudnicki A, Rachwalski M, Wiepszowski Ł, Sawicka E. Secondary alveolar bone grafting in cleft lip and palate: A comparative analysis of donor site morbidity in different age groups. J Craniomaxillofac Surg. 2019 Jan;47(1):165-169. [PubMed]
26. Verdier EF, Saloux AL, Azzis OM, Lebullenger R, Davit-Béal TA, Brézulier DY. Bioglass 45S5, a relevant alternative to autogenous harvesting for secondary alveolar bone grafts in clefts? Retrospective study of one hundred surgeries. J Cranio-Maxillofac Surg. 2024 Jan;52(1):85-92. [PubMed]
27.Courvoisier A, Maximin MC, Baroncini A. Safety and Efficacy of Stand-Alone Bioactive Glass Injectable Putty or Granules in Posterior Vertebral Fusion for Adolescent Idiopathic and Non-Idiopathic Scoliosis. Children (Basel). 2023 Feb 17;10(2):398. [PubMed]
28.Reissmann DR, Dietze B, Vogeler M, Schmelzeisen R, Heydecke G. Impact of donor site for bone graft harvesting for dental implants on health-related and oral health-related quality of life. Clin Oral Implants Res. 2013 Jun;24(6):698-705. [PubMed]
29.Viney C. Chapter I.1.3 - Bulk Properties of Materials. In: Biomaterials Science (Third Edition) An Introduction to Materials in Medicine Ratner BD, Hoffman AS, Schoen FJ, Lemons JE. editors. Elsevier. 2013, p. 9-21. [Crossref]
30. Fu Q, Saiz E, Rahaman MN, Tomsia AP. Bioactive glass scaffolds for bone tissue engineering: state of the art and future perspectives. Mater Sci Eng C Mater Biol Appl. 2011 Oct 10;31(7):1245-56. [PubMed]
31. Jónsson BY, Mjöberg B. Porous titanium granules are better than autograft bone as a bone void filler in lateral tibial plateau fractures: A randomized trial. Bone Joint J. 2015 Jun;97-B(6):836-41. [PubMed]
32. Jones JR, Brauer DS, Hupa L, Greenspan DC. Bioglass and bioactive glasses and their impact on healthcare. Int J Appl Glass Sci. 2016;7(4):423-34. [Crossref]
33. Salinas AJ, M. Vallet-Regi M, J. Heikkilä J. 12 - Use of bioactive glasses as bone substitutes in orthopedics and traumatology. In: Bioactive Glasses (Second Edition). Materials, Properties and Applications. Woodhead Publishing Series in Biomaterials. 2018, p. 337-364. [Crossref]
34. Wang H, Pei H, Chen M, Wang H. Incidence and predictors of surgical site infection after ORIF in calcaneus fractures, a retrospective cohort study. J Orthop Surg Res. 2018 Nov 20;13(1):293. [PubMed]
35.Hu S, Chang J, Liu M, Ning C. Study on antibacterial effect of 45S5 bioglass. J Mater Sci Mater Med. 2009 Jan;20(1):281-286. [PubMed]
36. Drago L, Romanò D, De Vecchi E, Vassena C, Logoluso N, Mattina R, et al. Bioactive glass BAG-S53P4 for the adjunctive treatment of chronic osteomyelitis of the long bones: an in vitro and prospective clinical study. BMC Infect Dis. 2013 Dec 10;13:584. [PubMed]
37. Heinig O, Feicht E, Mahamid A, Liberson R, Picard C, Liberson A. Treatment of a compound calcaneus fracture Sanders IV with an external circular fixator and calcaneal osteotomy. Trauma Case Rep. 2023 May 20;46:100850. [PubMed]
Received: 21 March 2024
Published online: 02 August 2024
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