Radiographic evaluation of the complications of long bone allografts.
OBJECTIVE
To study the long-term results of long bone allografts in patients with benign and malignant bone tumors.


METHODS
Forty patients for whom full clinical and radiological information was held were investigated in order to assess the overall incidence of complications including fractures, nonunion, hardware problems, infections, and bone resorption.


RESULTS
There were four deaths; four more patients had distant metastases and one patient had a recurrent chondrosarcoma. Seventeen patients (42%) had either no complications (nine patients) or only minor ones (eight patients). Eleven patients (27%) sustained fractures of either their allograft (eight patients) or of their hardware (three patients). Hardware problems occurred in nine patients (22.5%), six of whom had serious problems requiring revision. The majority of the fractures and hardware problems occurred in younger male patients (82%). Infection occurred in five patients (12.5%), two of whom required revision, while two cases were superficial. Dissolution of the allograft occurred in 12 patients (30%), 7 of whom required removal of the allograft. Ten of these 12 patients were female.


CONCLUSIONS
The long-term survival of long bone allografts is not as good as generally reported if an adequate follow-up time period is used. Most of the fractures and hardware problems occurred in the younger active male patients, whose activities should probably be curtailed. Resorption of the allograft is another serious complication which appears to occur mainly in female patients and could possibly be controlled by chemotherapy.
Griffiths
H J
HJ
Department of Radiology, University of Minnesota Hospital and Clinic, Minneapolis, 55455, USA.
Anderson
J R
JR
Thompson
R C
RC
Amundson
P
P
Detlie
T
T
D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D001862:Bone Resorption / Q000000981:diagnostic imaging; D016025:Bone Transplantation / Q000009:adverse effects* / Q000000981:diagnostic imaging*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D005599:Fractures, Ununited / Q000000981:diagnostic imaging; D006085:Graft Survival; D006801:Humans; D016268:Internal Fixators; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D012737:Sex Factors; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging; D013997:Time Factors; D014184:Transplantation, Homologous