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Evaluation of long-term outcomes of pasteurized autografts in limb salvage surgeries for bone and soft tissue sarcomas

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Pasteurized autografts used in limb salvage operations for malignant musculoskeletal tumors have several advantages, including reduced disease transmission, economic efficiency, accessibility, and anatomical conformation. However, their use has been associated with bone absorption, fracture, and pseudarthrosis. Few studies exist which have assessed the long-term outcomes of pasteurized autografts. The purpose of this study was to investigate the clinical outcomes of patients treated with pasteurized autografts and to compare these outcomes across various graft types.

Methods

A retrospective analysis of 46 patients treated with pasteurized autografts between 1992 and 2010 was conducted. The analysis included 22 intercalary bone grafts, 17 inlay grafts, 4 composite grafts, and 3 osteochondral grafts, with the mean follow-up period of 8.7 years (2–17 years).

Results

The 10-year survival rate of the 46 pasteurized autograft cases analyzed was 93.5 %, and the average bone union time between host and pasteurized autogenous bone was 9.5 months. Infections were identified in 6 (13 %) patients, fractures in 7 (15 %) patients, non-union in 8 (17 %) patients, and bone absorption in 6 (13 %) patients. Inlay grafts were completely incorporated with the host bone at the follow-up period. Combination with a vascularized fibular graft significantly reduced the risk of non-union and bone absorption (p < 0.05 and p < 0.01, respectively), with an average functional score of 23.1/30 (83.8 %).

Conclusion

Our findings show that pasteurized bone grafts in combination with vascularized fibular grafts have improved outcomes and potential clinical indications.

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Acknowledgments

We thank Mitsuru Takahashi, MD, Hirohisa Katagiri, MD, Keisuke Nakanishi, MD, and Masahiro Yonekawa, MD for patient recruitment and Keiko Iwashima for administrative assistance and manuscript preparation. The authors declare that the study complies with the current laws of Japan.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

Each author certifies that his institution has approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan

    Hideshi Sugiura & Kenji Yamada

  2. Department of Orthopaedic Surgery, Nagoya University School of Medicine, Nagoya, Japan

    Yoshihiro Nishida & Satoshi Tsukushi

  3. Department of Orthopaedic Surgery, Aichi Hospital, Okazaki, Japan

    Hiroatsu Nakashima

  4. Department of Orthopaedic Surgery, Nagoya Memorial Hospital, Nagoya, Japan

    Yoshihisa Yamada

Authors
  1. Hideshi Sugiura
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  2. Yoshihiro Nishida
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  3. Hiroatsu Nakashima
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  4. Yoshihisa Yamada
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  5. Satoshi Tsukushi
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  6. Kenji Yamada
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Corresponding author

Correspondence to Hideshi Sugiura.

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Sugiura, H., Nishida, Y., Nakashima, H. et al. Evaluation of long-term outcomes of pasteurized autografts in limb salvage surgeries for bone and soft tissue sarcomas. Arch Orthop Trauma Surg 132, 1685–1695 (2012). https://doi.org/10.1007/s00402-012-1606-4

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  • DOI: https://doi.org/10.1007/s00402-012-1606-4

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