J Korean Orthop Assoc.  2023 Aug;58(4):341-347. 10.4055/jkoa.2023.58.4.341 .

Allograft Reconstruction Following the Segmental Resection of Malignant Bone Tumors in the Long Bones

• Kim KJ
• Cha Y
• Baik KH
• Kim H

• KMID: 2545294
• DOI: http://doi.org/10.4055/jkoa.2023.58.4.341

Abstract

Purpose
We evaluated the treatment outcomes of allograft reconstruction following the segmental resection of malignant bone tumors in the long bones.
Materials and Methods
Eight patients were included in the study. The mean age was 40 years (range, 12–62). Five of the subjects were male, and three were female. The mean follow-up period was 104 months (range, 16–178). The mean Musculoskeletal Tumor Society (MSTS) score at the final follow-up was evaluated. Postoperative complications were assessed by periodic radiologic follow-ups. Oncologic results were analyzed at the final follow-up.
Results
The primary malignancies occurred in the femur in five cases, the humerus in one case and the tibia in two cases. The pathologic diagnoses were osteosarcoma in five cases, multiple myeloma in two cases, and adamantinoma in one case. The mean length of the allograft was 163 mm (range, 110–195). The fixations of the allograft were intramedullary nailing with an additional plate in four cases, intramedullary nailing in two cases, screw fixation in one case, and plate fixation in one case. The mean time to union was 14 weeks (range, 10–18). The mean MSTS score at the final follow-up was 20 points (range, 16–26). The postoperative complications included nonunion in three cases, implant failure in two cases, infection in one case, and an allograft fracture in one case. Six patients were continuous disease free and two patients were alive with disease at the final follow-up when assessed for oncologic outcomes. Autologous bone grafts and hemi-cortical onlay grafts were performed in two cases of nonunion and an implant change was performed in one case.
Conclusion
Allograft reconstruction following the segmental resection of malignant bone tumors in the long bones was an effective surgical option. However, the possibility of nonunion between the host bone and the allograft should be considered. It was observed that the wider and closer the contact between the host bone and allograft interface, the higher the union rate achieved.

Keyword

malignant bone tumor; segmental resection; allograft