Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr;99-B(4):522-530.
doi: 10.1302/0301-620X.99B4.BJJ-2016-0443.R2.

Is there still a role for osteoarticular allograft reconstruction in musculoskeletal tumour surgery? a long-term follow-up study of 38 patients and systematic review of the literature

M P A Bus  1 , M A J van de Sande  1 , A H M Taminiau  1 , P D S Dijkstra  1
Affiliations

Is there still a role for osteoarticular allograft reconstruction in musculoskeletal tumour surgery? a long-term follow-up study of 38 patients and systematic review of the literature

M P A Bus et al. Bone Joint J. 2017 Apr.

Abstract

Aims: To assess complications and failure mechanisms of osteoarticular allograft reconstructions for primary bone tumours.

Patients and methods: We retrospectively evaluated 38 patients (28 men, 74%) who were treated at our institution with osteoarticular allograft reconstruction between 1989 and 2010. Median age was 19 years (interquartile range 14 to 32). Median follow-up was 19.5 years (95% confidence interval (CI) 13.0 to 26.1) when 26 patients (68%) were alive. In addition, we systematically searched the literature for clinical studies on osteoarticular allografts, finding 31 studies suitable for analysis. Results of papers that reported on one site exclusively were pooled for comparison.

Results: A total of 20 patients (53%) experienced graft failure, including 15 due to mechanical complications (39%) and three (9%) due to infection. In the systematic review, 514 reconstructions were analysed (distal femur, n = 184, 36%; proximal tibia, n = 136, 26%; distal radius, n = 99, 19%; proximal humerus, n = 95, 18%). Overall rates of failure, fracture and infection were 27%, 20%, and 10% respectively. With the distal femur as the reference, fractures were more common in the humerus (odds ratio (OR) 4.1, 95% CI 2.2 to 7.7) and tibia (OR 2.2, 95% CI 1.3 to 4.4); infections occurred more often in the tibia (OR 2.2, 95% CI 1.3 to 4.4) and less often in the radius (OR 0.1, 95% CI 0.0 to 0.8).

Conclusion: Osteoarticular allograft reconstructions are associated with high rates of mechanical complications. Although comparative studies with alternative techniques are scarce, the risk of mechanical failure in our opinion does not justify routine employment of osteoarticular allografts for reconstruction of large joints after tumour resection. Cite this article: Bone Joint J 2017;99-B:522-30.

Keywords: Limb-salvage surgery; Osteoarticular allografts; Reconstruction after tumour resection.

PubMed Disclaimer

MeSH terms