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Long-term Results for Limb Salvage with Osteoarticular Allograft Reconstruction

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Clinical Orthopaedics and Related Research®

Abstract

Osteoarticular allograft reconstruction after extremity tumor resection has been shown to have a high rate of complications. Although good functional results have been seen, long-term outcomes have not been well studied. We performed a retrospective review of 20 patients who underwent primary osteoarticular allograft reconstruction after extremity sarcoma resection. All postoperative complications related to the allograft reconstruction were recorded. Musculoskeletal Tumor Society 1993 and Toronto Extremity Salvage Score scores were used for functional evaluation at last followup. Minimum followup was 10 years (mean, 16 years; range, 10–21 years). Seventy percent of patients experienced an event during the followup period. Recorded events were fracture (nine patients), progressive arthritis (five), nonunion (four), and infection (two). Sixty percent of allografts were removed at a mean of 5.2 years. Progressive arthritis led to total joint arthroplasty in five patients (25%). Mean Musculoskeletal Tumor Society and Toronto Extremity Salvage Score functional scores were 25 of 30 and 95% for patients who retained their original allograft. Osteoarticular allograft reconstruction for extremity sarcomas had a high rate of adverse events (70%) and allograft removal (60%) at long-term followup. Functional outcomes of patients with intact grafts were comparable to outcomes with segmental replacement prostheses reported in the literature.

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

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Acknowledgments

We thank Dr. Rachel L. Slotcavage for assistance in preparation and submission of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pennsylvania, 301 South 8th Street, Suite 2C, Philadelphia, PA, 19106-6192, USA

    Christian M. Ogilvie MD, Eileen A. Crawford MD, Harish S. Hosalkar MD, MBMS (Orth), FCPS (Orth), DNB (Orth) & Richard D. Lackman MD

  2. Department of Orthopaedic Surgery, Drexel University, Philadelphia, PA, USA

    Joseph J. King MD

Authors
  1. Christian M. Ogilvie MD
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  2. Eileen A. Crawford MD
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  3. Harish S. Hosalkar MD, MBMS (Orth), FCPS (Orth), DNB (Orth)
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  4. Joseph J. King MD
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  5. Richard D. Lackman MD
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Corresponding author

Correspondence to Richard D. Lackman MD.

Additional information

One or more of the authors (EAC, JJK) have received funding (research fellowship) from Stryker-Howmedica-Osteonics, Mahwah, NJ. One of the authors (RDL) is a consultant for Stryker-Howmedica-Osteonics, Mahwah, NJ.

Each author certifies that his or her 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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Ogilvie, C.M., Crawford, E.A., Hosalkar, H.S. et al. Long-term Results for Limb Salvage with Osteoarticular Allograft Reconstruction. Clin Orthop Relat Res 467, 2685–2690 (2009). https://doi.org/10.1007/s11999-009-0726-9

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  • DOI: https://doi.org/10.1007/s11999-009-0726-9

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