Limb salvage in osteosarcoma using autoclaved tumor-bearing bone.
BACKGROUND
Tumor prostheses currently give the best short- and medium-term results for limb-salvage reconstruction procedures in the treatment of bone tumors. However, in developing countries, the cost of a tumor prosthesis is beyond the reach of much of the population. We report the use of autoclaved tumor-bearing bone in 10 patients, as an affordable alternative to the use of prostheses.


METHODS
This is a case series of 10 patients (mean age 19 years) with osteosarcoma who were treated at our hospital from 1998 to 2008, and followed up for a mean of 35 months (range 14 to 8). The femur was involved in six cases, the humerus in three cases, and the ulna in one case. The mean length of the autoclaved bone was 150 mm (range 60-210).


RESULTS
Bone union occurred in seven patients over an mean duration of 12 months (range 8-17). Three patients had non-union. Two of these had associated implant failure, with one of them also developing chronic infection, and the third is still being followed up. Two other patients had local recurrence.


CONCLUSIONS
The use of autoclaved tumor grafts provides an inexpensive limb-salvage option without sacrificing appropriate oncologic principles. A painless and stable limb is achievable, and the use of this technique can be further refined.
Department of Orthopaedics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Sarawak General Hospital, Kuching, Sarawak, Malaysia. klpan@fmhs.unimas.my
Kok Long
KL
Pan
Wai Hoong
WH
Chan
Gek Bee
GB
Ong
Shanmugam
S
Premsenthil
Mohammad
M
Zulkarnaen
Dayangku
D
Norlida
Zainal
Z
Abidin
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D016025:Bone Transplantation; D002648:Child; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D023821:Limb Salvage; D008297:Male; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D011379:Prognosis; D011859:Radiography; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D055815:Young Adult