Abstract
Objective: To evaluate outcome parameters after custommade diaphyseal replacement of femur and humerus in long term allograft failures.
Methods: A subset of osteo allograft reconstructions after tumour resection ultimately will fail in patients achieving long-term survival. The reasons for original allograft failure were fractures, osteonecrosis or delayed bony ingrowths and implant loosening (plates, nails).In this study patients had a failed massive allograft after tumor resection of humerus or femur. Alternative surgical approach to revising these reconstructions are endoprosthetic revisions to preserve limb function with minimal complications due to custom made modular diaphyseal replacement systems of femur or humerus, especially with short proximal or distal intramedullary anchoring.
Results: A series of custom made diaphyseal replacement systems of femur or humerus was done in our department demonstrating the feasibility of this technique. Most patients initially were treated because of malignant bone tumors like Ewing sarcoma or soft tissue tumours. Allograft fractures occured up to 49 month after initial tumour resection. The follow up included radiographic and clinical parameters. In all cases limb salvage, good function and pain relief was achieved.
Conclusion: Reconstruction of the diaphyseal aspect of the femur or humerus after failure of osteoarticular allograft with custom made diaphyseal replacement of femur and humerus is a good option to achieve limb salvage, good function and pain relief.
Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de
