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KMID : 0613319970030040221
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Journal of the Korean Bone and Joint Tumor Soceity
1997 Volume.3 No. 4 p.221 ~ p.228
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Clinical results of Limb Salvage Surgery with Allograft in the Treatment of Bone Tumors
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Kang Yong-Koo
Kim Jung-Man
Rhee Seung-Koo
Kim Hyoung-Min
Song Seok-Whan
Park Won-Jong
Shin Sang-Young
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Abstract
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After wide resection of bone tumors, the reconstructive methods of bony defect include the use of autograft, allograft or tumor prosthesis. Among these methods, allograft is most commonly used in western countries. However, this method is not common in Korea because the supply of allograft is not sufficient due to traditional customs. The purpose of this study was to analyse the clinical results of limb salvage surgery using allograft after bone tumor resection. From April 1992 to December 1996, fifteen patients who had been treated with allograft in bone tumors were reviewed. The duration of follow-up was at least 6 months(average, 23 months). There were 11 male cases and 4 female cases, and the age ranged from 13 years to 55 years(average, 27.5 years). Diagnoses were 10 osteosarcomas, 3 giant cell tumors, 1 chondrosarcomas, and 1 plasmacytoma. Among the 10 osteosarcomas, the locations included the proximal humerus in 2 cases, proximal femur in 2, distal femur in 5, and proximal tibia in 1. Among 3 giant cell tumors, there was 1 case each in the proximal humerus, distal femur and proximal tibia. The single cases of chondrosarcoma and plasmacytoma were both located in the proximal humerus, respectively. Among 15 cases, 11 received neoadjuvant chemotherapy. Reconstructive methods using allograft were arthrodesis in 10 cases, allograft prosthesis composite graft in 3, and intercalary allograft in 2. The final oncologic status was died of disease(DOD) in 3 patients and continuous disease free(CDF) in 13. There was no local recurrence. Postoperative complications included infection in 3(20%) cases, delayed union in 3(20%) and resorption of the graft in 2(13.3%). In 8 cases who had primary bone union, the average union time was 6 months in the metaphyseal site, and 10 months in the diaphyseal site. Functional result by modified ISOLS score averaged 71.7%. Although the complication rate was relatively high in the early stage of reconstruction, the clinical results were good. Delayed or non-union was salvageable with autogenous bone graft. However, infection and resorption were difficult to salvage.
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KEYWORD
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Bone tumor, Allograft, Limb salvage, Complication
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