Abstract
Introduction: Osteoarticular allograft represents a reliable option for distal femur reconstruction. The purpose of this study was to describe the technical details and results of distal femur tumor resection and reconstruction with an osteoarticular allograft.
Material and Methods: One hundred and twenty-two patients who received an osteoarticular allograft after distal femur resection were reviewed, with a mean follow-up of 7 years. Key points for successful fixation are allograft selection, absolute stability and satisfactory soft-tissue reconstruction at the time of surgery that allows aggressive rehabilitation. Survival of the allograft was estimated with the Kaplan-Meier method. Functional and radiographic results were documented according to the Musculoskeletal Tumor Society scoring system at the time of the latest follow-up.
Results: Three patients were lost to follow and twenty-three patients died for tumor related reasons without allograft failure. In the remaining 96 allografts, eighteen allografts failed due to 7 infections, 7 local recurrences, 1 massive resorption and 3 fractures. Overall allograft survival was 82% +/− 7.6% (+/− 2 SE) at five and ten years. Those patients who preserved the original allograft had an average functional score of 27 points and a mean radiographic score of 89%, which represents a good and excellent functional and radiographic result.
Discussion and conclusion: Osteoarticular allograft is a successful procedure for reconstruction of the distal femur. Adequate preoperative planning, careful surgical technique and aggressive rehabilitation lead to excellent function and low complication rate.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
