Long-term results from use of pasteurized bone.
BACKGROUND
Pasteurized bone (PB) is recycled bone. The pasteurization has a tumor cell-killing effect wit retention of initial strength. However, few reports have been published on its long-term course; thus, in this study, we evaluated the long-term course of use of PB and examined appropriate reconstruction methods.


METHODS
We reviewed 27 cases in which reconstructive surgery using PB was performed between 1990 and 2002. Of these, we excluded 12 fatal cases and 1 case in which follow-up was discontinued. Therefore, our final analysis consisted of 14 cases with an average follow-up period of 165 months. The reconstruction methods used were: osteoarticular graft in 6 cases, composite graft with prosthesis in 3 cases, intercalary graft in 1 case, and reconstruction using PB from the pelvis in 4 cases.


RESULTS
The PB survived in 7 of the 14 cases. Five and 10-year survival of the PB was 78.6 and 47.6%, respectively. Three of the 6 osteoarticular cases failed because of late-onset absorption or infection of the PB. For patients with composite graft or intercalary graft, long-term survival was achieved when small amounts of PB were used. For patients with pelvic grafts, long-term survival was achieved in a case of P1 pelvis, but large PB grafts on small bone-junction surfaces were not successful in the long term. On the basis of these results, we were able to achieve successful long-term results with small PB grafts on large bone-junction surfaces.


CONCLUSIONS
To prevent bone absorption and achieve long-term survival of PB, it is important to use a small PB graft and create a large surface area of contact with normal bone. These factors are advantageous to PB survival and to gaining limb function.
Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. koyaorth@tmd.ac.jp
Hirotaka
H
Koyanagi
Seiichi
S
Matsumoto
Takashi
T
Shimoji
Taisuke
T
Tanizawa
Keisuke
K
Ae
Kenichi
K
Shinomiya
Atsushi
A
Okawa
Noriyoshi
N
Kawaguchi
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D061352:Pasteurization; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult