The Journal of Bone and Joint Surgery, Vol 69, Issue 8 1177-1188, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
The treatment of adamantinoma of the tibia by wide resection and allograft bone transplantation
MC Gebhardt, FC Lord, AE Rosenberg and HJ Mankin
Orthopaedic Oncology Service, Massachusetts General Hospital, Boston 02114.
Since 1975, nine patients who had adamantinoma of the tibia were treated by
the orthopaedic oncology service of the Massachusetts General Hospital and
the Children's Hospital, Boston, Massachusetts. All patients were followed
for two years or more or until a relapse occurred (mean length of
follow-up, 5.3 years). Five of the patients were female and four were male;
their ages ranged from fourteen to fifty-six years (mean, 19.1 years). The
treatment consisted of staging, wide surgical resection of the tumor, and
insertion of a segment of intercalary bone allograft (eight patients) or an
osteoarticular segment (one patient). All grafts were fixed with
compression plates and screws. All but two of the allografts had united at
both the proximal and the distal host-donor junction site by twelve months.
None of the patients had a local recurrence but pulmonary metastases
developed in one. Four of the patients had complications that affected the
final result. The functional results were excellent in five patients, good
in one, fair in one, and a failure in two. Seven of the nine patients were
asymptomatic and fully functional at the time of writing; only one needed a
brace to walk. On the basis of this experience we recommend wide resection
and implantation of an intercalary allograft in the treatment of
adamantinoma of the tibia.
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