Background and purpose: Curettage followed by autografts or allografts has been the preferred method for treating benign bone tumors. However, the development of synthetic substances, such as bioactive glass (BAG), has prompted interest in the medical community. This meta-analysis of randomized controlled trial (RCTs) aimed to compare the adverse event rates between BAG and autograft or allograft following curettage for benign bone tumors.
Methods: We searched PubMed, EMBASE, and Cochrane Central for RCTs comparing BAG versus autograft or allograft after curettage for benign bone tumors. The primary endpoint was tumor recurrence. Secondary endpoints included rates of overall complications, mild complications, and reoperations. Risk ratios (RRs) with 95 % CIs were pooled across trials.
Results: Four RCTs encompassing 156 patients were included, with 80 (51.3 %) receiving BAG. The most common lesions were enchondromas (24.4 %) and aneurysmal bone cysts (21.8 %). Recurrence rates were comparable between the BAG group (18.7 %) and the bone grafts (21.0 %) group (RR 0.91; 95 % CI 0.52 to 1.61; p = 0.75; I2: 0 %). Reoperation (RR 1.53; 95 % CI 0.64 to 3.66; p = 0.34; I2 = 0 %), overall complications (RR 0.72; 95 % CI 0.46 to 1.13; p = 0.15; I2 = 0 %), and mild complications (RR 0.54; 95 % CI 0.16 to 1.86; p = 0.33; I2 = 21 %) were also comparable. Longer follow-up subanalysis showed analogous results.
Conclusions: BAG appears as effective as autografts or allografts regarding recurrence, reoperation, and complication rates after curettage of benign bone tumors. Larger RCTs with more standardized approaches are needed for validation.
Keywords: Allograft; Autograft; Benign bone tumors; Bioactive glass; Curettage.
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