Objective

To compare osseous regeneration efficacy of allogeneic bone versus bone-induced calcium phosphate biomaterial (biological artificial material induced artificial bone, BAM-induced artificial bone) in treating tibial infected bone defects.

Methods

This study was a prospective study that enrolled participants hospitalized at Sichuan Orthopedic Hospital for tibial osteomyelitis. These subjects had undergone osteomyelitis surgery and presented with bone defects requiring bone grafting under controlled infection conditions. Participants meeting inclusion criteria for tibial infected bone defects were divided into observation group (BAM-induced artificial bone) or control group (allogeneic bone) based on their bone graft material selection. The observation group used BAM-induced artificial bone (OICPC, Bayamon Corp) mixed with autologous iliac bone as the surgical graft material. The control group used allogeneic bone mixed with autologous iliac bone as the surgical graft material. Both materials were applied for bone defect reconstruction during surgery. Digital radiography (DR) imaging examinations were performed at three timepoints (postoperative, 3 months postoperative, 6 months postoperative) to evaluate osseous regeneration. Image J software then analyzed void ratios and absorption rates in the grafted areas. SPSS statistical analysis compared differences between the two graft materials.

Results

A total of 56 subjects with infected bone defects were included in this study, of which 50 cases ultimately included for statistical analysis (observation group: 19 men and 7 women with a mean age of 44.12; control group: 18 men and 6 women with a mean age of 45.83). Postoperative radiographic evaluation showed varying degrees of bone absorption in both the observation group and the control group. No significant difference in void ratio was observed between the two groups immediately after surgery (observation group: 17.09 ± 3.84, control group: 18.12 ± 2.63; t = 1.101, p = .277). At 3 and 6 months postoperatively, both groups demonstrated increased void ratio and absorption rate compared to the immediate postoperative values and the increase in the observation group was significantly lower than control group. At 3 months postoperatively, the void ratio and absorption rate in the observation group were significantly lower than control group (20.67 ± 3.78 vs 23.56 ± 4.34, t = 2.488, p = .016; 3.58 ± 2.73 vs 5.44 ± 3.39, t = 2.118, p = .039). At 6 months postoperatively, the void ratio and absorption rate in the observation group were significantly lower than control group (27.20 ± 5.46 vs 31.83 ± 4.71, t = 3.175, p = .002; 10.11 ± 5.25 vs 13.71 ± 4.54, t = 2.566, p = .014); Severe absorption voids (void ratio >33%) incidence in the control group (8 cases, 16%) was higher than the observation group (2 cases, 4%).

Conclusion

BAM-induced artificial bone demonstrated superior bone-forming efficacy compared to allogeneic grafts, exhibiting significantly lower resorption rates and reduced post-grafting cavitation. Furthermore, it achieved enhanced osseous quality, optimized weight-bearing zone reconstruction, and greater functional callus formation volume relative to allogeneic bone transplantation.

Search results

Imaging observation of allogeneic bone and bone-induced calcium phosphate biomaterials as supplements in the treatment of infectious bone defects