Outcomes of Bone Void Filler for Oncology Indications: A Single-Center Experience and Review of the Literature

Background Benign bone tumors are frequently managed by curettage and grafting with autograft, allograft, or synthetic fillers. This study aims to evaluate the safety, efficacy, and radiographic incorporation of CERAMENT, a ceramic bone graft substitute (BGS), in patients following resection of benign bone lesions. Methods This retrospective chart review included 78 patients treated by the senior author between 2017 and 2023 for benign bone tumors utilizing curettage and BGS. Pre-operative imaging was used to determine the location, type, and size of each lesion, while operative notes documented the defect measurements and the amount of bone filler used. Post-operative radiographs and notes were used to assess complications and monitor graft incorporation, resorption, and bone regeneration. Results Patients were followed for an average of 12.7 months, during which five lesion recurrences were observed, with three requiring reoperation. One patient experienced a post-surgical pathological fracture. No fractures occurred during the early healing phase of the graft material in the absence of recurrence of the underlying bone tumor. Partial but progressive graft resorption and incorporation with bone healing was evident at 3-months. By 3 months, 88% of patients achieved full weight-bearing status. Advanced or complete graft resorption and incorporation was identified in 72.5% (37/51) of patients at 6-months, 80.6% (28/36) at 1-year, and 84.0% (21/25) at 2-years. Puddling of the BGS was noted in 27.4% of patients at 6-weeks (20/73), persisting in 12% of patients (3/25) at 2-years. The pattern of incorporation was commonly centripetal through a zone of peripheral radiolucency. Radiographic evidence of filler in soft tissue was noted early but resolved over time without clinical manifestation. Conclusion These findings support CERAMENT as a safe and effective option with a desirable profile of paced bone resorption and incorporation, leading to bone healing in benign bone tumors.