title: The outcomes of reconstruction using frozen autograft combined with iodine-coated implants for malignant bone tumors: compared with non-coated implants.
abstract: OBJECTIVE
  We perform reconstruction using frozen tumor bone treated by liquid nitrogen after excision of malignant bone tumors. To prevent post-operative infection, we use iodine-coated implants that we developed. The purpose of this study is to compare the outcome of reconstruction using frozen autograft with non-coated implants (group N) and iodine-coated implants (group I).
  
  
  METHODS
  Sixty-two patients were included in group N. The mean age was 31.9 ± 2.3 years. A total of 20 patients died and two were lost to follow-up, averaging 20.0 ± 2.9 months post-operatively, leaving 40 patients available for an assessment at a mean of 79.1 ± 5.8 months post-operatively. There were 38 patients in group I. The mean age was 29.8 ± 3.9 years. The mean follow-up period was 32.1 ± 3.0 months. All patients were alive at the latest follow-up. Survival of frozen bone was determined by Kaplan-Meier analysis.
  
  
  RESULTS
  In group N, survival of frozen bone was 80.7 ± 6.0% and 57.4 ± 10.2% at 5 and 10 years, respectively. Complications were encountered in 31 of 62 patients (50.0%), including deep infection in 10 (16.1%), fracture in 11 (17.7%), local soft-tissue recurrence in 6 (9.7%) and bone absorption in 4 (6.5%). In group I, survival of frozen bone was 86.7 ± 6.3% at 5 years. Complications were encountered in 8 of 38 patients (21.1%), including deep infection in one (2.6%), fracture in four (10.5%), local soft-tissue recurrence in two (5.3%) and bone absorption in one (2.6%). There was a significantly lower infection rate in group I (P = 0.032).
  
  
  CONCLUSIONS
  Reconstruction using frozen autograft combined with iodine-coated implants for patients with malignant bone tumor is very useful method in which good limb function can be gained with minimized risk of infection.
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan shirai.t77@gmail.com.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Shirai
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto.
authors.forename: Ryu
authors.initials: R
authors.lastname: Terauchi
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto.
authors.forename: Shinji
authors.initials: S
authors.lastname: Tsuchida
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto.
authors.forename: Naoki
authors.initials: N
authors.lastname: Mizoshiri
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Igarashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miwa
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kubo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000401:mortality / Q000628:therapy*; D016025:Bone Transplantation; D001842:Bone and Bones / Q000737:chemistry* / Q000000981:diagnostic imaging; D002648:Child; D005260:Female; D005615:Freezing; D006801:Humans; D007455:Iodine / Q000737:chemistry*; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007455:Iodine
keywords: frozen autograft; iodine-coated implants; post-operative infection; sarcoma