Objective： To evaluate the functional outcome and complications of allograft replacement in management of bone tumors. Methods： Between March 1992 and September 2002, 164 patients underwent bone tumor resection and ...Objective： To evaluate the functional outcome and complications of allograft replacement in management of bone tumors. Methods： Between March 1992 and September 2002, 164 patients underwent bone tumor resection and massive allograft reconstruction of bone defects. The length of the resected part ranged from 5-35 cm. The resections were classified as marginal or wide resections of the tumor on the basis of the Musculoskeletal Tumor Society staging system. Fresh-frozen allografts were employed as osteoarticular grafts （n = 95）, hemi-condylar （n = 15）, massive （n = 23）, allograft-prosthesis composite （n = 12）, intercalary grafts （n = 15） or hemi-pelvic grafts （n = 4）. Most of the lesions were osteosarcoma and giant cell tumor of bone and located in proximal and distal femur, proximal tibia and humerus. Results： At a median follow-up of 47 months （range, 12 to 168 months） after the operation, 154 of the patients in the study were free of disease and 10 died of disease. Twenty-one （12.8%） patients had local recurrence and 38 （23.2%） nonunion. Late complications included 11 （6.7%） fractures of the allograft and 18 （11.0%） infections of the graft, instability of the joint in the form of subluxation was noted in 13 （7.9%） patients. Ten extremities were amputated due to local recurrence or severe infection. Conclusion： AIIografts can be used for reconstruction of bony defects after tumor resection. AIIograft has nearly similar shape, strength, osteo-inductivity and osteo-conductivity with host bone. AIIograft implantation is a high complication reconstruction method, and the dsk of recurrence increases when less surgical margin achieves.展开更多
Objective： To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis i...Objective： To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs. Methods： Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis （8 cases of nonunion ） underwent one-stage allograft after debridement in our hospital. Results： Thirty-five cases were followed up for an average period of 28 months （ range, 13 to 55 months）, in which 32 cases （91.43%） were found no infection, and 3 cases （8.57%） were confirmed recurrence of infection. Four out of 8 cases of bone nonunion healed in 9.5 months on average （ range, 3 to 12 months）, and another case also acquired union after redebridement and autograft of iliumdue to infection recurrence 35 days after surgery. Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment. Conclusions： A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.展开更多
文摘Objective： To evaluate the functional outcome and complications of allograft replacement in management of bone tumors. Methods： Between March 1992 and September 2002, 164 patients underwent bone tumor resection and massive allograft reconstruction of bone defects. The length of the resected part ranged from 5-35 cm. The resections were classified as marginal or wide resections of the tumor on the basis of the Musculoskeletal Tumor Society staging system. Fresh-frozen allografts were employed as osteoarticular grafts （n = 95）, hemi-condylar （n = 15）, massive （n = 23）, allograft-prosthesis composite （n = 12）, intercalary grafts （n = 15） or hemi-pelvic grafts （n = 4）. Most of the lesions were osteosarcoma and giant cell tumor of bone and located in proximal and distal femur, proximal tibia and humerus. Results： At a median follow-up of 47 months （range, 12 to 168 months） after the operation, 154 of the patients in the study were free of disease and 10 died of disease. Twenty-one （12.8%） patients had local recurrence and 38 （23.2%） nonunion. Late complications included 11 （6.7%） fractures of the allograft and 18 （11.0%） infections of the graft, instability of the joint in the form of subluxation was noted in 13 （7.9%） patients. Ten extremities were amputated due to local recurrence or severe infection. Conclusion： AIIografts can be used for reconstruction of bony defects after tumor resection. AIIograft has nearly similar shape, strength, osteo-inductivity and osteo-conductivity with host bone. AIIograft implantation is a high complication reconstruction method, and the dsk of recurrence increases when less surgical margin achieves.
文摘Objective： To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs. Methods： Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis （8 cases of nonunion ） underwent one-stage allograft after debridement in our hospital. Results： Thirty-five cases were followed up for an average period of 28 months （ range, 13 to 55 months）, in which 32 cases （91.43%） were found no infection, and 3 cases （8.57%） were confirmed recurrence of infection. Four out of 8 cases of bone nonunion healed in 9.5 months on average （ range, 3 to 12 months）, and another case also acquired union after redebridement and autograft of iliumdue to infection recurrence 35 days after surgery. Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment. Conclusions： A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.
