2515. Serial Radiographic Appearance of Cerament Bone Graft Substitute in Various Orthopedic Surgery Applications
Authors * Denotes Presenting Author
  1. Bryeson Rodgers *; Mayo Clinic Alix School of Medicine
  2. Krista Gouldling; Mayo Clinic Arizona
  3. Jonathan Flug; Mayo Clinic Arizona
  4. Jeremiah Long; Mayo Clinic Arizona
Cerament is a synthetic bone graft substitute used in various orthopedic surgeries and visible radiographically. A relatively unique feature of this material is its progressive decrease in radiographic density. This investigation analyzed the postoperative radiographic appearance of Cerament synthetic bone graft substitute over time.

Materials and Methods:
This single institution, multisite retrospective study received IRB approval. The electronic medical record identified all surgical cases using Cerament bone graft substitute with at least 12 months of postoperative radiographs available. Cases where the Cerament material could not be definitively identified on the first postoperative radiographs were excluded. Clinical and surgical details were recorded. Patient radiographs were reviewed in consensus by the authors. Radiographs were analyzed for visibility, size, and relative density of the Cerament material. In addition, the morphology of Cerament material density was characterized.

Our search identified 19 cases in 18 patients fitting our study criteria. Surgeries were performed between 2016 and 2020 and included: arthroplasties (10 cases), bone tumor surgeries (6 cases) and osteonecrosis surgeries (3 cases). The patient population consisted of 12 women and 6 men with an average patient age of 46 years (range 15 – 71 years). Radiographic analysis showed that in all cases the Cerament progressively decreased in density over time and, when visible, was higher in density than surrounding trabecular bone. In all but one case, the Cerament became imperceptible radiographically over time with an average time of 7.6 months to radiographic imperceptibility. The Cerament morphologies visible radiographically were categorized as: no specific pattern (60%), puddle pattern (19%), halo pattern (10.5%), and marble pattern (10.5%).

In our study cohort, the average time to radiographic imperceptibility was 7.6 months for 18 of our 19 cases. Knowledge of this material and its radiographic properties is critical for radiologists to avoid misinterpreting decreasing graft site density as a pathologic process.