Pupose: The purpose of this study was to analyze the outcome of proximal tibia osteoarticular allografts after tumor resections.

Material amd Methods: We performed a retrospective study over 58 patients in which a proximal tibia allograft reconstruction was undertaken. All patients were followed for a minimum of 5 years and allografts survival from the date of implantation to the date of revision or the time of the latest follow-up was determined with the use of the Kaplan-Meier method. In all patients, the patellar tendon from the host was reattached by suturing to overlapped donor flaps. Patients were clinically evaluated with the MSTS score system.

Results: The global rate of allograft survival was 65% +/− 12% (+/− 2 SE) at five and ten years, with no significant difference between patients who received chemotherapy and those who did not. Allografts needed to be removed in twenty patients due to 12 infection, 4 local recurrences and 4 fractures. Active knee extension was restored in all patients with an average functional score of 26.3 points.

Discussion: Survival analysis showed that 65% of proximal tibia osteoarticular allograft reconstructions remain stable at five and ten years. Patellar tendon reconstruction with allogeneic tissue in proximal tibia allograft restores active knee extension with an excellent functional result. Despite the incidence of complications, proximal tibia osteoarticular allografts continue to be a very valuable reconstructive procedure for large defects after resection of bone tumors.

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.