title: The clinical and radiological evaluation of the use of an allograft-prosthesis composite in the treatment of proximal femoral giant cell tumours.
abstract: Giant cell tumour is the most common aggressive benign tumour of the musculoskeletal system and has a high rate of local recurrence. When it occurs in proximity to the hip, reconstruction of the joint is a challenge. Options for reconstruction after wide resection include the use of a megaprosthesis or an allograft-prosthesis composite. We performed a clinical and radiological study to evaluate the functional results of a proximal femoral allograft-prosthesis composite in the treatment of proximal femoral giant cell tumour after wide resection. This was an observational study, between 2006 and 2012, of 18 patients with a mean age of 32 years (28 to 42) and a mean follow-up of 54 months (18 to 79). We achieved excellent outcomes using Harris Hip Score in 13 patients and a good outcome in five. All allografts united. There were no complications such as infection, failure, fracture or resorption of the graft, or recurrent tumour. Resection and reconstruction of giant cell tumours with proximal femoral allograft-prosthesis composite is a better option than using a prosthesis considering preservation of bone stock and excellent restoration of function. A good result requires demanding bone banking techniques, effective measures to prevent infection and stability at the allograft-host junction.
authors.affiliation: All India Institute of Medical Sciences, Department of Orthopaedics, AIIMS, New Delhi-29, India.
authors.forename: R
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: All India Institute of Medical Sciences, Department of Orthopaedics, AIIMS, New Delhi-29, India.
authors.forename: G N
authors.initials: GN
authors.lastname: Kiran Kumar
authors.affiliation: All India Institute of Medical Sciences, Department of Orthopaedics, AIIMS, New Delhi-29, India.
authors.forename: V
authors.initials: V
authors.lastname: K Digge
authors.affiliation: All India Institute of Medical Sciences, Department of Orthopaedics, AIIMS, New Delhi-29, India.
authors.forename: V
authors.initials: V
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D064595:Composite Tissue Allografts / Q000000981:diagnostic imaging; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005269:Femur / Q000637:transplantation; D018212:Giant Cell Tumor of Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D019736:Prostheses and Implants; D011859:Radiography; D016896:Treatment Outcome; D063986:Vascularized Composite Allotransplantation / Q000379:methods; D055815:Young Adult
keywords: Allograft; Giant cell tumour; Harris hip score; Proximal femur