Effect of Tricalcium Phosphate on Healing of Non-Unions: An Observational Study of over 400 Non-Unions

Therapeutics and Clinical Risk Management, 2023 · DOI: https://doi.org/10.2147/TCRM.S409119 · Published: May 12, 2023

Simple Explanation

This study investigates how well tricalcium phosphate (TCP), a bone substitute, helps heal bone non-unions (fractures that don't heal properly). The research looked at over 400 non-unions in nearly 400 patients. The study compared patients who received TCP mixed with their own bone graft to those who received only their own bone graft or no graft at all. Researchers assessed bone stability one and two years after surgery. The results showed that TCP, when combined with a patient's own bone, can be effective in reconstructing complicated bone defects, although it may take longer than using the patient's bone alone.

Study Duration

24 Months

Participants

393 patients with 404 non-unions

Evidence Level

Observational study

Key Findings

1
After 2 years, 72.7% of the TCP+BG patients, 90.1% of the BG patients and 84.4% of the NBG patients achieved a consolidation score ≥3.
2
Advanced age, presence of comorbidities and longer treatment period had a significantly negative effect on consolidation 1 year after surgery.
3
Longer treatment periods also showed a negative significant effect after 2 years.

Research Summary

The study evaluated the effect of tricalcium phosphate (TCP) on the healing of non-unions in a large cohort of patients. The combination of TCP and autologous bone grafts shows good results in the reconstruction of complicated bone defects. Patient-specific factors like age, comorbidities, smoking, and length of treatment influence the outcome of non-union healing.

Practical Implications

Bone defect reconstruction

TCP can be a reliable option to combine with autologous bone-graft when bone defects are large.

Extended healing time

Clinicians should expect a longer healing period (up to 2 years) when using TCP.

Patient-specific factors

Patient health and lifestyle choices can influence non-union healing and should be considered.

Study Limitations

1
Retrospective design
2
Lack of control groups
3
Number of previous surgeries undergone by patients in external hospitals could not be reliably determined

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