title: The long-term outcome following the use of frozen autograft treated with liquid nitrogen in the management of bone and soft-tissue sarcomas.
abstract: In 1999, we developed a technique for biological reconstruction after excision of a bone tumour, which involved using autografts of the bone containing the tumour treated with liquid nitrogen. We have previously reported the use of this technique in 28 patients at a mean follow up of 27 months (10 to 54). In this study, we included 72 patients who underwent reconstruction using this technique. A total of 33 patients died and three were lost to follow-up, at a mean of 23 months (2 to 56) post-operatively, leaving 36 patients available for a assessment at a mean of 101 months 16 to 163) post-operatively. The methods of reconstruction included an osteo-articular graft in 16, an intercalary in 13 and, a composite graft with prosthesis in seven. Post-operative function was excellent in 26 patients (72.2%), good in seven (19.4%), and fair in three (8.3%) according to the functional evaluation system of Enneking. No recurrent tumour occurred within the grafts. The autografts survived in 29 patients (80.6%), and the rates of survival at five and ten years were 86.1% and 80.6 %, respectively. Seven of 16 osteo-articular grafts (44%) failed because of fracture or infection, but all the composite and intercalary grafts survived. The long-term outcomes of frozen autografting, particularly using composite and intercalary grafts, are satisfactory and thus represent a good method of treatment for patients with a sarcoma of bone or soft tissue.
authors.affiliation: Kanazawa University, Department of Orthopaedic Surgery, 13-1 Takaramachi, Kanazawa 920-8641, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Igarashi
authors.forename: N
authors.initials: N
authors.lastname: Yamamoto
authors.forename: T
authors.initials: T
authors.lastname: Shirai
authors.forename: K
authors.initials: K
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Nishida
authors.forename: H
authors.initials: H
authors.lastname: Kimura
authors.forename: A
authors.initials: A
authors.lastname: Takeuchi
authors.forename: H
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005615:Freezing; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008875:Middle Aged; D009584:Nitrogen; D012516:Osteosarcoma / Q000601:surgery; D012509:Sarcoma / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000379:methods; D014182:Transplantation, Autologous / Q000379:methods; D016896:Treatment Outcome
chemical_list: D009584:Nitrogen
keywords: Bone sarcoma; Composite graft; Cryosurgery; Frozen autograft; Intercalary graft; Limb salvage surgery; Osteoarticular graft; Soft-tissue sarcoma