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KMID : 0922220120120010006
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Journal of the Korean Musculoskeletal Transplantation Society
2012 Volume.12 No. 1 p.6 ~ p.16
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Complication of Reconstruction with Structural Alloggrafts for Massive Bone Defects
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Kang Yong-Koo
Chung Yang-Guk
Park Won-Jong
Rhee Seung-Koo
Lee An-Hi
Park Jeong-Mi
Chung Joon-Young
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Abstract
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Purpose: To analyze the complication rate of structural allografts for reconstruction of massive bone defects.
Materials and Methods: The incidence of allograft-related complications were evaluated in twenty-nine patients with massive bone defects from various causes, which have been managed with structural allografts and followed up more than 8 months since December 1, 2004. The mean age was 40.1 years old (ranged 11 to 79 years). The most common cause of massive bone defects was resection of primary malignant bone tumors or metastatic carcinomas in 18 patients. The types of allografts were allograft-prosthesis composites in 15, inlay strut graft in 7, osteochondral allograft in 4 etc. The mean follow up period was 30.7 months (ranged 8 to 84 months).
Results: In thirteen out of 29 patients (44.8%), at least one complication was occurred. Nonunion was the most common complication and developed in 8 among 37 applicable sites (21.6%). Delayed unions were developed in 2 sites (5.4%). In contrast to none of thirteen metaphyseal sites, 10 out of 24 diaphyseal sites revealed nonunion or delayed union. Two allograft infections with delayed soft tissue disruption were developed, which were not related infected allograft itself. Focal bone resorptions were occurred in 3 patients without mechanical deteriorations. Two allograft fractures were occurred, one of which was related to repeating heavy mechanical loading in manual laborer.
Conclusion: The complication rate after reconstruction of massive bone defects using structural allografts was still high. However with appropriate care for surgical procedures and postoperative management, we can reduce the complication rate of structural allografts, especially nonunions and infections.
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KEYWORD
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Bone defect, Structural allograft, Complication, Nonunion, Infection
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