BONE CEMENT Fills in Breaks and Cracks.

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When 90-year-old Maude Oosterhof splintered her wrist in a fall in the garage of her Menlo Park, Calif., home late in 1999, she expected a long recovery in a cast and worried that her fragile bones might never mend. She was surprised when Stanford (Calif.) University Medical Center reconstructive surgeon Amy Ladd said she could "paste" the wrist back together with an injectable, quick-setting bone cement. Today Oosterhof's wrist is not only mended, she can play the piano, a practice she had abandoned years ago. "It's good exercise, and I even enjoy my mistakes," she says. Oosterhof's repaired wrist also gives her the ability to write notes, cook meals, and work a bit in her garden.

Ladd, associate professor of functional restoration, is one of a rare, but increasing, number of physicians who use needles and high-tech cements to fill in gaps and strengthen injured bones in wrists, hips, and spines. Also using bone cements at Stanford are Huy M. Do, assistant professor of radiology, who utilizes it to repair spines; and Stuart Goodman, chief of the Division of Orthopaedic Surgery, who uses it for patients who might otherwise require complex hip reconstruction for avascular necrosis (bone death).

The relatively quick, less-invasive procedure is often performed under regional anesthesia and offers significant pain relief within hours or days--seemingly too good to be true to patients who may have been severely incapacitated by their injury. "I was awake and talking to the doctors the whole time," notes Oosterhof. The alternative for her would have been a lengthy, major surgical procedure under general anesthesia that would require harvesting some of her own bone as a graft.

Although Ladd's patient was in her 90s, the procedure is "especially useful for relatively young patients--those in their 40s--who want to remain active without facing a long period of recovery and relative inactivity," indicates Goodman. "For them, the short hospital stay and rapid recovery are tremendous advantages."

Ladd and Goodman use a product called Norian SRS (Skeletal Repair System), which they say has the advantage of allowing the body to replace the cement with new bone growth over time. That's because the cement, a special formula of calcium phosphate--the naturally occurring mineral of bone--is biocompatible and defers to the body's natural inclination to repair itself over time.

Cement treatments are not for everyone, though, caution the doctors who use it...

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