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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 5, 704-709.
doi: 10.1302/0301-620X.87B5.15491  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Reconstruction after intercalary resection of malignant bone tumours

COMPARISON BETWEEN SEGMENTAL ALLOGRAFT AND EXTRACORPOREALLY-IRRADIATED AUTOGRAFT

T. H. Chen, MD, Chairman; W. M. Chen, MD, Chief, Division of Orthopaedics and Traumatology; and C. K. Huang, MD, Orthopaedic Surgeon

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec 2, Shi-Pai Road, Taipei 112, Taiwan.

Correspondence should be sent to Dr T. H. Chen; e-mail: thchen{at}vghtpe.gov.tw

We reviewed 29 patients who had undergone intercalary resection for malignant tumours. Of these, 14 had received segmental allograft reconstruction and 15 extracorporeally-irradiated autograft.

At a mean follow-up of 71 months (24 to 132), 20 were free from disease, five had died and four were alive with pulmonary metastases. Two patients, one with an allograft and one with an irradiated autograft, had a local recurrence. Reconstruction with extracorporeally-irradiated autograft has a significantly lower rate of nonunion (7% vs 43%, p = 0.031) but an insignificantly higher rate of fracture (20% vs 14%, p = 0.535) than that with segmental allograft. Using the Enneking functional evaluation system, the mean postoperative score for the patients without local recurrence was 87% (80% to 96%) and was similar in both groups.

Extracorporeally-irradiated autograft could be an acceptable alternative for reconstruction after intercalary resection, especially in countries where it is difficult to obtain allografts.




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