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Allograft Reconstruction After Sarcoma Resection in Children Younger Than 10 Years Old

  • Symposium: New Approaches to Allograft Transplantation
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Preservation of limb function in pediatric oncology patients is challenging with the ongoing growth of limbs contralateral to reconstructed limbs. We analyzed 22 patients younger than 10 years old who received an allograft after resection of a bone sarcoma with a minimum followup of 2 years (mean, 4 years; range, 2–14 years). The mean age was 7 years (range, 2–10 years). There were 16 boys and six girls with 17 osteosarcomas and five Ewing’s sarcomas. Thirteen reconstructions were performed with an intercalary allograft and nine with an osteoarticular allograft. Physes were uninvolved in five patients and one physis in 17. We documented outcomes using the Musculoskeletal Tumor Society functional and the International Society of Limb Salvage radiographic scoring systems. At last followup, three of the 22 patients died of their tumor, one was alive but with an amputation, and 18 retained their limbs. These 18 patients had an average functional score of 27 points and a mean radiographic score of 94%. Eight complications required a second surgery; in four, the allograft was removed (one infection, one local recurrence, two fractures) and in four, the allograft was preserved (two local recurrences, one fracture, one nonunion). We consider biologic reconstruction with allografts after sarcoma resection an appropriate reconstructive procedure in young children.

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

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Authors and Affiliations

  1. Institute of Orthopedics “Carlos E. Ottolenghi”, Italian Hospital of Buenos Aires, Potosí 4215 (1199), Buenos Aires, Argentina

    D. Luis Muscolo MD, Miguel A. Ayerza MD, Luis Aponte-Tinao MD & German Farfalli

Authors
  1. D. Luis Muscolo MD
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  2. Miguel A. Ayerza MD
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  3. Luis Aponte-Tinao MD
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  4. German Farfalli
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Correspondence to D. Luis Muscolo MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his institution has approved the reporting of this case report and that all investigations were conducted in conformity with ethical principles of research.

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Muscolo, D.L., Ayerza, M.A., Aponte-Tinao, L. et al. Allograft Reconstruction After Sarcoma Resection in Children Younger Than 10 Years Old. Clin Orthop Relat Res 466, 1856–1862 (2008). https://doi.org/10.1007/s11999-008-0303-7

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  • DOI: https://doi.org/10.1007/s11999-008-0303-7

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