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Security and reliability of CUSTOMBONE cranioplasties: A prospective multicentric study

J-P Lejeune 1 M. Baroncini P-L Henaux Patrick Toussaint 2 Johann Peltier 3, 2 K. Buffenoir 4 O. Hamel 5, 6 P. Dam Hieu S. Chibbaro 7 P. Kehrli 8 M. A. Lahlou P. Menei 9 M. Lonjon 10 C. Mottolese 11 P. Peruzzi K. Mahla D. Scarvada C. Le Guerinel 12 P. Caillaud C. Nuti B. Pommier 13 T. Faillot 14 G. Iakovlev S. Goutagny N. Lonjon 15, 16, 17 P. Cornu P. Bousquet P. Sabatier B. Debono J-P Lescure E. Vicaut 18 S. Froelich 19 A. Amelot A. Nataloni P. Francois 20 A-R Cook 
Abstract : Background. - Repairing bone defects generated by craniectomy is a major therapeutic challenge in terms of bone consolidation as well as functional and cognitive recovery. Furthermore, these surgical procedures are often grafted with complications such as infections, breaches, displacements and rejections leading to failure and thus explantation of the prosthesis. Objective. - To evaluate cumulative explantation and infection rates following the implantation of a tailored cranioplasty CUSTOMBONE prosthesis made of porous hydroxyapatite. One hundred and ten consecutive patients requiring cranial reconstruction for a bone defect were prospectively included in a multicenter study constituted of 21 centres between December 2012 and July 2014. Follow-up lasted 2 years. Results. - Mean age of patients included in the study was 42 I 15 years old (y.o), composed mainly by men (57.27%). Explantations of the CUSTOMBONE prosthesis were performed in 13/110 (11.8%) patients, significantly due to infections: 9/13 (69.2%) (p<0.0001), with 2 (15.4%) implant fracture, 1 (7.7%) skin defect and 1 (7.7%) following the mobilization of the implant. Cumulative explantation rates were successively 4.6% (SD 2.0), 7.4% (SD 2.5), 9.4% (SD 2.8) and 11.8% (SD 2.9%) at 2, 6, 12 and 24 months. Infections were identified in 16/110 (14.5%): 8/16 (50%) superficial and 8/16 (50%) deep. None of the following elements, whether demographic characteristics, indications, size, location of the implant, redo surgery, co -morbidities or medical history, were statistically identified as risk factors for prosthesis explantation or infection. Conclusion. - Our study provides relevant clinical evidence on the performance and safety of CUSTOMBONE prosthesis in cranial procedures. Complications that are difficulty incompressible mainly occur during the first 6 months, but can appear at a later stage (>1 year). Thus assiduous, regular and long-term surveillances are necessary. (C) 2021 Elsevier Masson SAS. All rights reserved.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03599580
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Soumis le : lundi 7 mars 2022 - 11:55:46
Dernière modification le : mercredi 28 septembre 2022 - 16:20:12

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J-P Lejeune, M. Baroncini, P-L Henaux, Patrick Toussaint, Johann Peltier, et al.. Security and reliability of CUSTOMBONE cranioplasties: A prospective multicentric study. Neurochirurgie, Elsevier Masson, 2021, 67 (4), pp.301-309. ⟨10.1016/j.neuchi.2021.02.007⟩. ⟨hal-03599580⟩

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