title: Intercalary femur and tibia segmental allografts provide an acceptable alternative in reconstructing tumor resections.
abstract: Intercalary femur and tibia segmental allografts were implanted in 59 consecutive patients after segmental resection-52 for malignant and seven for benign aggressive bone tumors. The patients were followed up for an average of 5 years. Allograft survival was determined with the Kaplan-Meier method. Infection, fracture, and nonunion rates were determined. The overall 5-year survivorship for the 59 intercalary allografts was 79%, and we found no significant differences between allograft survival in patients receiving or not receiving adjuvant chemotherapy. Infection and fracture rates were 5% and 7% respectively. From 118 host-donor junctions, 11 did not initially heal (9%). The nonunion rate (10 of 69 osteotomies) for diaphyseal junctions was higher than the rate (one of 49 osteotomies) for metaphyseal junctions. Although some patients required reoperations because of allograft complications, it seems that the use of intercalary allograft clearly has a place in the reconstruction of a segmental defect created by the resection of a tumor in the diaphyseal and /or metaphyseal portion of the femur or tibia.
authors.affiliation: Institute of Orthopedics Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: D Luis
authors.initials: DL
authors.lastname: Muscolo
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Ayerza
authors.forename: Luis
authors.initials: L
authors.lastname: Aponte-Tinao
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Ranalletta
authors.forename: Eduardo
authors.initials: E
authors.lastname: Abalo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016025:Bone Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005266:Femoral Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D016019:Survival Analysis; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014184:Transplantation, Homologous