Complications of massive allograft reconstruction for bone tumors
BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft ha...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2006-11-01
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| Series: | Journal of Research in Medical Sciences |
| Subjects: | |
| Online Access: | http://journals.mui.ac.ir/jrms/article/view/109 |
| _version_ | 1828757226952589312 |
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| author | Abolhasan Borjian Khalil Nazem Hadi Yassine |
| author_facet | Abolhasan Borjian Khalil Nazem Hadi Yassine |
| author_sort | Abolhasan Borjian |
| collection | DOAJ |
| description | BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD). Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60%) were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb reconstruction. |
| first_indexed | 2024-12-11T00:23:09Z |
| format | Article |
| id | doaj.art-1ce60ebbf4224cc48d6e09c62662932e |
| institution | Directory Open Access Journal |
| issn | 1735-1995 1735-7136 |
| language | English |
| last_indexed | 2024-12-11T00:23:09Z |
| publishDate | 2006-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Research in Medical Sciences |
| spelling | doaj.art-1ce60ebbf4224cc48d6e09c62662932e2022-12-22T01:27:39ZengWolters Kluwer Medknow PublicationsJournal of Research in Medical Sciences1735-19951735-71362006-11-01114240247Complications of massive allograft reconstruction for bone tumorsAbolhasan BorjianKhalil NazemHadi YassineBACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD). Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60%) were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb reconstruction.http://journals.mui.ac.ir/jrms/article/view/109Bone tumors, bone allograft, limb reconstruction. |
| spellingShingle | Abolhasan Borjian Khalil Nazem Hadi Yassine Complications of massive allograft reconstruction for bone tumors Journal of Research in Medical Sciences Bone tumors, bone allograft, limb reconstruction. |
| title | Complications of massive allograft reconstruction for bone tumors |
| title_full | Complications of massive allograft reconstruction for bone tumors |
| title_fullStr | Complications of massive allograft reconstruction for bone tumors |
| title_full_unstemmed | Complications of massive allograft reconstruction for bone tumors |
| title_short | Complications of massive allograft reconstruction for bone tumors |
| title_sort | complications of massive allograft reconstruction for bone tumors |
| topic | Bone tumors, bone allograft, limb reconstruction. |
| url | http://journals.mui.ac.ir/jrms/article/view/109 |
| work_keys_str_mv | AT abolhasanborjian complicationsofmassiveallograftreconstructionforbonetumors AT khalilnazem complicationsofmassiveallograftreconstructionforbonetumors AT hadiyassine complicationsofmassiveallograftreconstructionforbonetumors |