The Journal of Bone and Joint Surgery, Vol 76, Issue 4 549-554, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Osteoarticular allografts for reconstruction after resection of a musculoskeletal tumor in the proximal end of the tibia
DR Clohisy and HJ Mankin
Massachusetts General Hospital, Boston 02114.
An osteoarticular allograft was used to reconstruct a skeletal deficiency
in sixteen patients after resection of a tumor in the proximal end of the
tibia. The status of each allograft and the condition of each involved limb
were evaluated an average of nine years (range, six to fourteen years)
postoperatively. The status of the allograft was evaluated according to the
survival of the allograft and the occurrence of complications. Of the
original sixteen allografts, seven were removed: six, between two and five
years after the reconstruction and one, seven years after the
reconstruction. A second reconstruction with use of an allograft was
performed in five of the seven patients. Fifteen complications occurred in
association with eleven of the original sixteen allografts. These included
fracture of the allograft (five patients), subchondral collapse (five
patients), infection (two patients), non-union (two patients), and
instability of the joint (one patient). At the latest follow-up
examination, nine patients had retained the original allograft, five had
had a second allograft procedure, and two had had an above-the-knee
amputation. The most recent result was rated excellent or good in eleven
patients and fair or a failure in five, with use of the system of Mankin et
al. It was rated good or excellent in nine patients and fair, poor, or a
failure in six, and it was not rated in one patient who had died, according
to the system of the Musculoskeletal Tumor Society.(ABSTRACT TRUNCATED AT
250 WORDS)
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