Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma.
For skeletal reconstruction in surgery for bone tumors, pasteurization of bone has been used with favorable results over autoclaving or boiling. Twenty-three patients with primary malignant bone tumors and two patients with soft tissue sarcoma invading bone reconstruction surgery with pasteurized autologous bone graft comprised the study group. There were 16 females and nine males, between 7 and 77 years of age who were followed up for at least 3 years (mean, 52 months). The International Society of Limb Salvage graft evaluation method was used for evaluation of the radiographs. Fifteen patients (60%) had complete incorporation of the graft and eight patients (32%) had partial incorporation. Viability of the grafts was evaluated by bone scintigraphy. Of 22 patients evaluated, uptake was detected in 17 patients from approximately 6 months postoperatively after which it increased gradually. The functional results were assessed by the system of the Musculoskeletal Tumor Society, and the mean functional rating was 86%. Eighteen patients have been disease-free and seven have died of disease. Fracture (12%) and infection (20%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone may be a useful option for reconstruction after resection of malignant bone tumors. The advantages of extracorporeal pasteurization include convenience of use, avoidance of intraspecies infection and allogenic reactions, and satisfactory bone remodeling.
Manabe
Jun
J
Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. manabe@jfcr.or.jp
Ahmed
Adel Refaat
AR
Kawaguchi
Noriyoshi
N
Matsumoto
Seiichi
S
Kuroda
Hiroshi
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000601:surgery*; D011877:Radionuclide Imaging; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging / Q000601:surgery*; D013242:Sterilization / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D034941:Upper Extremity