Clinical Orthopaedics and Related Research®

, Volume 470, Issue 3, pp 728–734 | Cite as

Intercalary Femur Allografts Are an Acceptable Alternative After Tumor Resection

  • Luis Aponte-TinaoEmail author
  • Germán L. Farfalli
  • Lucas E. Ritacco
  • Miguel A. Ayerza
  • D. Luis Muscolo
Symposium: 2010 Musculoskeletal Tumor Society



With the improved survival for patients with malignant bone tumors, there is a trend to reconstruct defects using biologic techniques. While the use of an intercalary allograft is an option, the procedures are technically demanding and it is unclear whether the complication rates and survival are similar to other approaches.


We evaluated survivorship, complications, and functional scores of patients after receiving intercalary femur segmental allografts.

Patients and Methods

We retrospectively reviewed 83 patients who underwent an intercalary femur segmental allograft reconstruction. We determined allograft survival using the Kaplan-Meier method. We evaluated patient function with the Musculoskeletal Tumor Society scoring system. Minimum followup was 24 months (median, 61 months; range, 24–182 months).


Survivorship was 85% (95% confidence interval: 93%–77%) at 5 years and 76% (95% confidence interval: 89%–63%) at 10 years. Allografts were removed in 15 of the 83 patients: one with infection, one with local recurrence, and 13 with fractures. Of the 166 host-donor junctions, 22 (13%) did not initially heal. Nonunion rate was 19% for diaphyseal junctions and 3% for metaphyseal junctions. We observed an increase in the diaphysis nonunion rate in patients fixed with nails (28%) compared to those fixed with plates (15%). Fracture rate was 17% and related to areas of the allograft not adequately protected with internal fixation. All patients without complications had mainly good or excellent Musculoskeletal Tumor Society functional results.


Diaphyseal junctions have higher nonunion rates than metaphyseal junctions. The internal fixation should span the entire allograft to avoid the risk of fracture. Our observations suggest segmental allograft of the femur provides an acceptable alternative in reconstructing tumor resections.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.


Distraction Osteogenesis Nonunion Rate Allograft Failure Musculoskeletal Tumor Society Segmental Bone Defect 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Supplementary material 1 (MPG 3105 kb)

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Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Luis Aponte-Tinao
    • 1
    Email author
  • Germán L. Farfalli
    • 1
  • Lucas E. Ritacco
    • 1
  • Miguel A. Ayerza
    • 1
  • D. Luis Muscolo
    • 1
  1. 1.Carlos E. Ottolenghi Institute of OrthopedicsItalian Hospital of Buenos AiresBuenos AiresArgentina

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