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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 7, 1009-1014.
doi: 10.1302/0301-620X.84B7.13032  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Hemicortical allograft reconstruction after resection of low-grade malignant bone tumours

R. L. M. Deijkers, MD, Orthopaedic Surgeon1; R. M. Bloem, MD, PhD, Orthopaedic Surgeon2; P. C. W. Hogendoorn, MD, PhD, Professor of Pathology3; J. J. Verlaan, MD, Orthopaedic Registrar2; H. M. Kroon, MD, PhD, Radiologist4; and A. H. M. Taminiau, MD, PhD, Professor of Orthopaedics2

1 Department of Orthopaedic Surgery, Reinier de Graaf Gasthuis, Reinier de Graafweg, 3, 2625 AD Delft, The Netherlands.
2 Department of Orthopaedic Surgery
3 Department of Pathology
4 Department of Radiology, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands.

Correspondence should be sent to Dr R. L. M. Deijkers

Low-grade surface tumours of bone may theoretically be treated by hemicortical resection, retaining part of the circumference of the cortex. An inlay allograft may be used to reconstruct the defect. Since 1988 we have performed 22 hemicortical procedures in selected patients with low-grade parosteal osteosarcoma (6), peripheral chondrosarcoma (6) and adamantinoma (10).

Restricted medullary involvement was not a contraindication for this procedure.

There was no evidence of local recurrence or distant metastasis at a mean follow-up of 64 months (27 to 135). Wide resection margins were obtained in 19 patients. All allografts incorporated completely and there were no fractures or infections. Fractures of the remaining hemicortex occurred in six patients and were managed successfully by casts or by osteosynthesis. The functional results were excellent or good in all except one patient.

Hemicortical procedures for selected cases of low-grade surface tumours give excellent oncological and functional outcomes. There was complete remodelling and fewer complications when compared with larger intercalary procedures. The surgery is technically demanding but gives good clinical results.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General