Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study
Abstract Background Allograft reconstruction following the resection of malignant bone tumors is associated with high rates of complications and failures. This study aimed to evaluate the efficacy and current problems of allograft reconstruction techniques to optimize treatment strategies at our cen...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-023-03121-7 |
| _version_ | 1797752735868649472 |
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| author | Qing Liu Feng Long Can Zhang Yupeng Liu Hongbo He Wei Luo |
| author_facet | Qing Liu Feng Long Can Zhang Yupeng Liu Hongbo He Wei Luo |
| author_sort | Qing Liu |
| collection | DOAJ |
| description | Abstract Background Allograft reconstruction following the resection of malignant bone tumors is associated with high rates of complications and failures. This study aimed to evaluate the efficacy and current problems of allograft reconstruction techniques to optimize treatment strategies at our center. Materials and methods Thirty-eight cases (16 men and 22 women), who were diagnosed with malignant bone tumors and had undergone allograft reconstruction, were recruited. Allograft was fixed by intramedullary nail, single steel plate, double plate, and intramedullary nail combined plate in 2, 4, 17, and 15 cases, respectively. Allograft union, local recurrence, and complications were assessed with clinical and radiological tests. Tumor grade was assessed using the Enneking staging of malignant bone tumors. Functional prognosis was evaluated by the Musculoskeletal Tumor Society (MSTS) scoring system. Results Intercalary and osteoarticular reconstructions were performed in 32 and 6 cases, respectively. Six patients underwent reoperation related to allograft complications, four patients had local recurrence, and three patients with allograft fracture underwent allograft removal. A total of eight host–donor junctions showed nonunion, including seven cases (18.4%) in diaphysis and one case (3.1%) in metaphysis (p < 0.01). Host rejection and secondary osteoarthritis occurred in nine and two cases, respectively. No deep infection and internal fixation device fracture occurred. The overall allograft survival rate was 81.6%. Postoperative MSTS score of patients with allograft survival was 26.8 ± 2.9, indicating a significant improvement as compared to their preoperative function. Conclusions Allograft represents an excellent choice for intercalary bone defects after malignant bone tumor resection. Robust internal fixation protection across the whole length of the allograft is an important prerequisite for the survival of the allograft, while multidimensional osteotomy, intramedullary cement reinforcement, and pedicled muscle flap transfer can effectively improve the survival rate and healing rate of the allograft. |
| first_indexed | 2024-03-12T17:08:48Z |
| format | Article |
| id | doaj.art-fa922f4335884f30bbd8d25785be3d58 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-12T17:08:48Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-fa922f4335884f30bbd8d25785be3d582023-08-06T11:16:23ZengBMCWorld Journal of Surgical Oncology1477-78192023-07-0121111310.1186/s12957-023-03121-7Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort studyQing Liu0Feng Long1Can Zhang2Yupeng Liu3Hongbo He4Wei Luo5Department of Orthopaedics, Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, Xiangya Hospital, Central South UniversityDepartment of Orthopaedics, Xiangya Hospital, Central South UniversityAbstract Background Allograft reconstruction following the resection of malignant bone tumors is associated with high rates of complications and failures. This study aimed to evaluate the efficacy and current problems of allograft reconstruction techniques to optimize treatment strategies at our center. Materials and methods Thirty-eight cases (16 men and 22 women), who were diagnosed with malignant bone tumors and had undergone allograft reconstruction, were recruited. Allograft was fixed by intramedullary nail, single steel plate, double plate, and intramedullary nail combined plate in 2, 4, 17, and 15 cases, respectively. Allograft union, local recurrence, and complications were assessed with clinical and radiological tests. Tumor grade was assessed using the Enneking staging of malignant bone tumors. Functional prognosis was evaluated by the Musculoskeletal Tumor Society (MSTS) scoring system. Results Intercalary and osteoarticular reconstructions were performed in 32 and 6 cases, respectively. Six patients underwent reoperation related to allograft complications, four patients had local recurrence, and three patients with allograft fracture underwent allograft removal. A total of eight host–donor junctions showed nonunion, including seven cases (18.4%) in diaphysis and one case (3.1%) in metaphysis (p < 0.01). Host rejection and secondary osteoarthritis occurred in nine and two cases, respectively. No deep infection and internal fixation device fracture occurred. The overall allograft survival rate was 81.6%. Postoperative MSTS score of patients with allograft survival was 26.8 ± 2.9, indicating a significant improvement as compared to their preoperative function. Conclusions Allograft represents an excellent choice for intercalary bone defects after malignant bone tumor resection. Robust internal fixation protection across the whole length of the allograft is an important prerequisite for the survival of the allograft, while multidimensional osteotomy, intramedullary cement reinforcement, and pedicled muscle flap transfer can effectively improve the survival rate and healing rate of the allograft.https://doi.org/10.1186/s12957-023-03121-7AllograftBone defect repairMalignant bone tumorInternal fixationBone healingLong-bone metaphysis |
| spellingShingle | Qing Liu Feng Long Can Zhang Yupeng Liu Hongbo He Wei Luo Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study World Journal of Surgical Oncology Allograft Bone defect repair Malignant bone tumor Internal fixation Bone healing Long-bone metaphysis |
| title | Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study |
| title_full | Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study |
| title_fullStr | Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study |
| title_full_unstemmed | Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study |
| title_short | Biological reconstruction of bone defect after resection of malignant bone tumor by allograft: a single-center retrospective cohort study |
| title_sort | biological reconstruction of bone defect after resection of malignant bone tumor by allograft a single center retrospective cohort study |
| topic | Allograft Bone defect repair Malignant bone tumor Internal fixation Bone healing Long-bone metaphysis |
| url | https://doi.org/10.1186/s12957-023-03121-7 |
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