title: Alcohol-inactivated autograft replantation with joint preservation in the management of osteosarcoma of the distal femur: a preliminary study.
abstract: OBJECTIVE
  To evaluate clinical outcomes in patients who underwent alcohol-inactivated autograft replantation with joint preservation for the treatment of osteosarcoma of the distal femur.
  
  
  METHODS
  10 patients (7 men, 3 women; mean age: 20.1 years) were treated. 9 patients had Enneking stage IIb tumors and 1 patient had stage III. The mean follow-up time was 34 months. All patients obtained first-stage healing.
  
  
  RESULTS
  1 patient died of local recurrence and multiple metastases 13 months after surgery; 3 patients died of multiple metastases 9, 12, and 24 months after surgery, respectively. 3 patients required second surgery because of fracture of the inactivated autograft, 1 patient died 6 months later, 1 patient experienced bony healing 4 months later with no further complications, and 1 patient required subsequent open reduction and bone implantation with internal fixation (bony healing was evident 6 months later; however, joint instability and limited knee flexion were apparent). At final follow-up, the mean International Society of Limb Salvage (ISOLS) graft score was 31 (87%), whereas the mean Musculoskeletal Tumour Society (MSTS) function score was 23 (77%).
  
  
  CONCLUSIONS
  These preliminary findings indicate that alcohol-inactivated autograft replantation with joint preservation may be effective in treating osteosarcoma of the distal femur in some patients. Larger-scale studies are needed to fully evaluate the efficacy/safety of this approach.
authors.affiliation: Orthopedic Department, The General Hospital of Jinan Military Commanding Region, Jinan, P. R. China.
authors.forename: Xiu-Chun
authors.initials: XC
authors.lastname: Yu
authors.forename: Song-Feng
authors.initials: SF
authors.lastname: Xu
authors.forename: Ming
authors.initials: M
authors.lastname: Xu
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Liu
authors.forename: Ruo-Xian
authors.initials: RX
authors.lastname: Song
authors.forename: Zhi-Hou
authors.initials: ZH
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D064592:Autografts / Q000000981:diagnostic imaging / Q000187:drug effects*; D016025:Bone Transplantation / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery*; D005269:Femur / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000187:drug effects / Q000601:surgery*; D008297:Male; D012516:Osteosarcoma / Q000601:surgery*; D010865:Pilot Projects; D011859:Radiography; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000431:Ethanol