Pasteurized autograft for intercalary reconstruction: an alternative to allograft

Abstract

Intercalary resection and reconstruction for tumors have become increasingly popular. We asked whether pasteurized autologous bone graft was comparable to other reported reconstruction methods regarding union rates, complications, and functional outcomes. We retrospectively analyzed the outcome of 21 intercalary pasteurized bones in lower extremities. Ultimate graft survival, union rate, and union time were evaluated as a function of clinical variables, such as age, gender, body mass index, location of intercalary segment, primary tumor type, use of chemotherapy, percentage and length of resected bone, type of junction, method of fixation, and iliac bone graft at index operation. The overall survival rate of pasteurized bone was 74% at 10 years. We identified no clinical variables associated with graft survival or union time. The union rate was related to length or percentage of resected segment and location of osteotomy. The rates of infection, fracture, and nonunion were three of 21, two of 21, and five of 21, respectively. Our results suggest reconstruction with pasteurized autograft is a simple and easily accessible method in limb salvage and an economic alternative to allograft, with low rates of ultimate failure and graft-related complications.