Abstract
Along with prosthetic components, a bone allograft is a major option to be considered in reconstructing a segmental bone loss after a primary malignant bone tumor resection.
In most cases of primary bone tumor surgery, segments of long bone will be used as allografts. These are sterilely procured in operating theatre after an organ procurement. To facilitate the reconstruction, the periarticular soft tissues along with the cartilage are also dissected free during the harvest.
Bone or osteochondral allografts can be implanted alone with osteosynthetic material or combined with a prosthesis. The allograft can be used as an osteoarticular end, an intercalary construct with or without arthrodesis or be implanted with a prosthesis.
The main indication for using bone allograft in 2003 are the intercalary bone loss, an osteoarticular defect at the upper limb, at the proximal tibia and femur if tendon insertions are to be resected and at an anatomical location where no reliable prosthetic material exists such as the scapula or distal fibula.
A risk of disease transmission and a high rate of fracture and nonunion are the main disadvantages of this material.
An anatomical reconstruction of the skeleton, the possibility to reinsert tendon insertion, the biologic anchorage of the graft with a bony callus, the absence of bone reaction to wear particles and the possibility to recreate a stable joint are among the advantages of using this bone grafting materials. With a bone allograft, virtually any segmental bone loss can be reconstructed.
Bone allografts remain a sound material to work with when dealing with a bone tumor. The surgeon must however anticipate the potential complications by performing an appropriate reconstruction.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
