Limb salvage with osteoarticular allografts after resection of proximal tibia bone tumors.
A retrospective study was performed between 1980 and 1995 on 38 recipients of proximal tibial allografts after wide resection of benign and malignant tumors. Twenty-one (55%) patients experienced one or more complications. Of the 26 patients who received chemotherapy, 15 (58%) experienced one or more complications, whereas of the 12 patients who did not receive chemotherapy, six (50%) experienced one or more complications. In the chemotherapy group, there were 12 (46%) fractures, four (15%) infections, three (12%) nonunions, and four (15%) instabilities. In the nonchemotherapy group there were three (25%) infections, two (17%) fractures, one (8%) instability, and one (8%) nonunion. These complications were managed adequately with multiple subsequent surgical procedures. Three patients underwent amputations for deep wound infections. Twelve (32%) patients underwent removal of the allograft, and the limb was salvaged by reallografting or by total knee arthroplasty. The results of both groups were 66% (25 of 38 patients) satisfactory (good or excellent). The chemotherapy group had a significantly higher incidence of fractures. All other complication rates and functional outcomes were not significantly different between these groups.
Department of Orthopaedics and Rehabilitation, University of Miami/Jackson Memorial Medical Center, FL 33101, USA.
F J
FJ
Hornicek
W
W
Mnaymneh
R D
RD
Lackman
G U
GU
Exner
T I
TI
Malinin
D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery* / Q000628:therapy; D016025:Bone Transplantation; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000601:surgery* / Q000628:therapy; D011183:Postoperative Complications / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D013977:Tibia / Q000637:transplantation; D013978:Tibial Fractures / Q000453:epidemiology; D014184:Transplantation, Homologous