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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1, 95-99.
doi: 10.1302/0301-620X.88B1.16253  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Allograft reconstruction for bone sarcoma of the tibia in the growing child

L. E. Ramseier, MD, Orthopaedic Surgeon1; T. I. Malinin, MD, Professor of Orthopaedic Surgery and Head Tissue Bone2; H. T. Temple, MD, Professor, Chief Orthopaedic Oncology Service2; W. A. Mnaymneh, MD, Orthopaedic Surgeon2; and G. U. Exner, MD, Professor, Head of Tumour and Paediatric Orthopaedics section1

1 Department of Orthopaedics University of Zürich, Balgrist, Forchstrasse 340, CH-8008 Zürich, Switzerland.
2 Department of Orthopaedics and Rehabilitation University of Miami School of Medicine, Miami, Florida 33101, USA.

Correspondence should be sent to Professor G. U. Exner; e-mail: guexner{at}balgrist.unizh.ch

The outcome of tibial allograft reconstruction after resection of a tumour is inconsistent and has a high rate of failure. There are few reports on the use of tibial allografts in children with open growth plates. We performed 21 allograft reconstructions (16 osteoarticular, five intercalary) in 19 consecutive patients between seven and 17 years of age. Two had Ewing’s sarcoma, one an adamantinoma and 16 osteosarcoma, one with multifocal disease.

Five patients have died; the other 14 were free from disease at the time of follow-up. Six surviving patients (eight allograft reconstructions) continue to have good or excellent function at a mean of 59 months (14 to 132). One patient has poor function at 31 months. The other seven patients have a good or excellent function after additional procedures including exchange of the allograft and resurfacing or revision to an endoprosthesis at a mean of 101 months (43 to 198). The additional operations were performed at a mean of 47 months (20 to 84) after the first reconstruction.

With the use of allograft reconstruction in growing children, joints and growth plates may be preserved, at least partially. Although our results remain inconsistent, tibial allograft reconstruction in selected patients may restore complete and durable function of the limb.




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