Technetium-99 m-MDP scintigraphy and long-term follow-up of musculo-skeletal sarcoma reconstructed with pasteurized autologous bone graft.
BACKGROUND
Local bone tumor excision followed by pasteurization and reimplantation is a unique technique of reconstruction for sarcoma patients. The long-term scintigraphic findings of pasteurized bone grafts in relation to clinical patients' data were reviewed retrospectively.


METHODS
Twenty-two sarcoma patients (mean age, 24 years) done between April 2000 and January 2004 constituted the material of this study. One hundred and fifty-two 99 m TC-methylene diphosphonate (MDP) whole-body scans were reviewed. Initially, all autografts appeared as photon deficient areas. Diffusely increased bone uptake was present at the osteotomy sites within 4-6 months after surgery, the uptake of the grafted pasteurized bone was detected in 17 patients from about 6 months after surgery.


RESULTS
Of 22 patients, 11 (50%) showed higher uptake than the normal bone, 6 (27%) had uptake similar to the normal bone, while 5 (23%) had less uptake than the normal bone. Radiologically, 15 patients (68%) showed complete incorporation of graft and 5 patients (23%) had partial incorporation. Oncologically, 16 patients are disease free, while 6 died of disease. No local recurrence was detected at a mean of 59 months, while fracture (13.6%) eventually healed with bone grafting and revision of internal fixation, graft collapse (9%) (needed revision arthroplasty) and infection (9%), one cured and one converted to rotationplasty, were the major complications encountered. Significantly more mechanical complications were seen when tracer uptake suggestive of revascularization occurred; thus, revascularization and partial bone ingrowth are not sufficient conditions for lower mechanical complication rate.


CONCLUSIONS
The method of pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors.
Ahmed
Adel Refaat
AR
PO4 Lamborozo Department of Orthopedic Surgery, Alexandria University, Alexandria, Egypt. egyptadel28@hotmail.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016025:Bone Transplantation; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging; D008875:Middle Aged; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging / Q000601:surgery; D013669:Technetium Tc 99m Medronate; D014182:Transplantation, Autologous; D055815:Young Adult
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate