The fate of hemijoint allografts after tumor resection about the knee.
Distal femoral or proximal tibial resection was performed in 15 patients for bone tumor and replaced by defrosted allogeneic osteoarticular transplants. The patients were followed for a median of 11 years (range 2 to 18 years). The major complications were 3 fractures, one delayed union, 3 graft resorptions, and one secondary infection to salvage by total knee prosthesis. Sixteen reoperations were performed in 8 patients. The small number of bone healing problems was accounted for by the autologous bone sleeve in the graft-host junction. The knee motion improved considerably after early mobilization in hinged orthosis. The early results (1 to 7 years) were as follows: excellent--3, good--6, and fair--6. The late results (8 to 18 years) were: good--4, fair--5, and poor--1. The poor result was salvaged to fair by arthrodesis. It is concluded that osteoarticular allografting yields an alternative to salvage the limb, but still presents unsolved immunologic and preservation problems which make the prognosis unpredictable.
Alho
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Orthopaedic Department, Ullevaal Hospital, University of Oslo, Norway.
D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D005266:Femoral Neoplasms / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007596:Joints / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D013977:Tibia / Q000601:surgery*; D014184:Transplantation, Homologous