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Comparable outcomes of recycled autografts and allografts for reconstructions in patients with high-grade osteosarcoma

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Abstract

Purpose

This retrospective, single-centre study compares the clinical and radiographic outcomes of limb reconstruction using recycled autografts to that using allografts.

Methods

Patients with histopathologically verified high-grade osteosarcoma treated with wide bone resection and limb reconstruction using allografts or recycled autografts from January 1998 through December 2012 were retrospectively screened for enrolment eligibility. The final study cohort included 255 patients (allograft, 91; recycled autograft, 164). Data regarding post-operative complications, salvage treatment, and graft survival were collected. A modified International Society of Limb Salvage classification system was used to evaluate the radiographic findings.

Results

The time to graft–host union did not differ significantly between the two graft types. Patients receiving recycled autografts had fewer complications compared than did those receiving allografts (recycled autografts vs. allograft: structural failure, 4.3 vs. 13.2%; late infection, 2.4 vs. 7.7%; all p < 0.05). Complications occurred most frequently during the first three years after surgery, and the majority were manageable. The five year limb survival rate did not differ significantly between the two graft types (91.3 vs. 94.0%; p = 0.752). No local oncological recurrence was observed within the recycled autografts.

Conclusion

Recycled autografts and allografts are feasible options for biological limb reconstructions in terms of complications and graft survival after wide resection of osteosarcoma.

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Data availability

All relevant data are within the manuscript and its Supporting Information files.

Code availability

Not applicable.

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Funding

This work was supported by the Veterans General Hospital-Taipei (V104C-001), Mrs. Sophie Chang, and Dr. Morris Chang. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript, and has no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC

    Kuan-Lin Chen, Chao-Ming Chen, Cheng-Fong Chen, Yu-Kuan Lin, Shang-Wen Tsai, Tain-Hsiung Chen, Po-Kuei Wu & Wei-Ming Chen

  2. Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC

    Kuan-Lin Chen, Chao-Ming Chen, Cheng-Fong Chen, Yu-Kuan Lin, Shang-Wen Tsai, Tain-Hsiung Chen, Po-Kuei Wu & Wei-Ming Chen

  3. Orthopaedic Department School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112, Taiwan ROC

    Kuan-Lin Chen, Chao-Ming Chen, Cheng-Fong Chen, Yu-Kuan Lin, Shang-Wen Tsai, Po-Kuei Wu & Wei-Ming Chen

  4. Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Taipei City, 112, Taiwan ROC

    Chao-Ming Chen, Shang-Wen Tsai & Po-Kuei Wu

  5. Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC

    Yu-Chi Cheng

  6. Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112, Taiwan (ROC)

    Yu-Kuan Lin

Authors
  1. Kuan-Lin Chen
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Contributions

Conceptualization: Chao-Ming Chen, Cheng-Fong Chen, Tain-Hsiung Chen, Po-Kuei Wu, Wei-Ming Chen; acquisition of data: Kuan-Lin Chen, Yu-Kuan Lin; analysis and interpretation of data: Yu-Chi Cheng, Shang-Wen Tsai; drafting of the manuscript: Kuan-Lin Chen, Yu-Chi Cheng, Yu-Kuan Lin, Po-Kuei Wu; critical revision of the manuscript: Chao-Ming Chen, Cheng-Fong Chen, Shang-Wen Tsai, Tain-Hsiung Chen, Wei-Ming Chen. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Po-Kuei Wu.

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Ethics approval

The study was approved by the institutional review board of Taipei Veterans General Hospital (IRB- 2016–05-013CC) prior to retrospective patient screening and enrollment, and was performed in accordance with the ethical principles set out in the 1964 Declaration of Helsinki.

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Cite this article

Chen, KL., Chen, CM., Chen, CF. et al. Comparable outcomes of recycled autografts and allografts for reconstructions in patients with high-grade osteosarcoma. International Orthopaedics (SICOT) 45, 2973–2981 (2021). https://doi.org/10.1007/s00264-021-05161-8

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  • DOI: https://doi.org/10.1007/s00264-021-05161-8

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