Abstract
Objective
To evaluate the functional outcome and complications of allograft replacement in management of bone tumors.
Methods
Between March 1992 and September 2002, 164 patients underwent bone tumor resection and massive allograft reconstruction of bone defects. The length of the resected part ranged from 5–35 cm. The resections were classified as marginal or wide resections of the tumor on the basis of the Musculoskeletal Tumor Society staging system. Fresh-frozen allografts were employed as osteoarticular grafts (n = 95), hemi-condylar (n = 15), massive (n = 23), allograft-prosthesis composite (n = 12), intercalary grafts (n = 15) or hemi-pelvic grafts (n = 4). Most of the lesions were osteosarcoma and giant cell tumor of bone and located in proximal and distal femur, proximal tibia and humerus.
Results
At a median follow-up of 47 months (range, 12 to 168 months) after the operation, 154 of the patients in the study were free of disease and 10 died of disease. Twenty-one (12.8%) patients had local recurrence and 38 (23.2%) nonunion. Late complications included 11 (6.7%) fractures of the allograft and 18 (11.0%) infections of the graft. Instability of the joint in the form of subluxation was noted in 13 (7.9%) patients. Ten extremities were amputated due to local recurrence or severe infection.
Conclusion
Allografts can be used for reconstruction of bony defects after tumor resection. Allograft has nearly similar shape, strength, osteo-inductivity and osteo-conductivity with host bone. Allograft implantation is a high complication reconstruction method, and the risk of recurrence increases when less surgical margin achieves.
Similar content being viewed by others
References
Sammarco VJ, Chang L. Modem issues in bone graft substitutes and advances in bone tissue technology. Foot Ankle Clin, 2002, 7: 19–41.
Sorger JI, Hornicek FJ, Zavatta M, et al. Allograft fractures revisited. Clin Orthop Relat Res, 2001, (382): 66–74.
Getty PJ, Peabody TD. Complications and functional outcomes of reconstruction with an osteoarticular allograft after intra-articular resection of the proximal aspect of the humerus. J Bone Joint Surg Am, 1999, 81: 1138–1146.
Mankin HJ, Gebhardt MC, Jennings LC, et al. Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res, 1996, (324): 86–97.
Hornicek FJ, Gebhardt MC, Tomford WW, et al. Factors affecting nonunion of the allograft-host junction. Clin Orthop Relat Res, 2001, (382): 87–98.
Brigman BE, Hornicek FJ, Gebhardt MC, et al. Allografts about the knee in young patients with high-grade sarcoma. Clin Orthop Relat Res, 2004, (421): 232–239.
Lietman SA, Tomford WW, Gebhardt MC, et al. Complications of irradiated allografts in orthopaedic tumor surgery. Clin Orthop Relat Res, 2000, (375): 214–217.
Cascio BM, Thomas KA, Wilson SC. A mechanical comparison and review of transverse, step-cut, and sigmoid osteotomies. Clin Orthop Relat Res, 2003, (411): 296–304.
Muscolo DL, Ayerza MA, Aponte-Tinao L, et al. Intercalary femur and tibia segmental allografts provide an acceptable alternative in reconstructing tumor resections. Clin Orthop Relat Res, 2004, (426): 97–102.
Langlais F, Lambotte JC, Collin P, et al. Long-term results of allograft composite total hip prostheses for tumors. Clin Orthop Relat Res, 2003, (414): 197–211.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Niu, X., Hao, L., Zhang, Q. et al. Massive allograft replacement in management of bone tumors. Chin. -Ger. J. Clin. Oncol. 7, 159–163 (2008). https://doi.org/10.1007/s10330-007-0182-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10330-007-0182-5