Massive intercalary bone allografts in the treatment of primary and secondary bone tumors

Abstract

From 1981 to 1993, 21 patients received intercalary bone allografts for reconstruction of the extremity after en bloc tumor resection (15 malignant and 6 benign tumors). The allografts were collected from multiorgan donors and cryopreserved at −70°C. The mean follow-up was 4.4 (range 1–13) years. The fate of the grafts was followed by conventional radiography, bone scintigraphy, and functional assessment. The overall survival rate of the 7 patients with high-grade malignancies was 86%. Solid union of the graft-host sites in less that 15 months occurred in 85%. An increased isotope uptake of the graft indicates that incorporation at the osteotomies as well as remodelling is still continuing at 9 years after operation. The overall complication rate was 43%; 3 patients had two or more complications. Complications were related to the allograft in 6 (infection or fatigue fracture in 1 and delayed healing in 4 cases) and to the osteosynthesis in 3 patients. The definitive results after treatment of complications show that satisfactory results have been obtained in all but 2 patients: 62% had excellent, 19% good, and 10% fair results. Intercalary allografts therefore provide a valuable solution for large skeletal defects after resection of bone tumors.