Overlapping allograft in reconstructive surgery for malignant bone tumours in paediatric patients: a preliminary report

J Bone Joint Surg Br. 2011 Apr;93(4):537-41. doi: 10.1302/0301-620X.93B4.25406.

Abstract

The use of allografts for the treatment of bone tumours in children is limited by nonunion and the difficulty of finding a suitable graft. Furthermore, appositional growth can't be expected of an allograft. We used an overlapping allograft in 11 children, with a mean age of ten years (4 to 15), with a mean follow-up of 24.1 months (20 to 33). There were five intercalary and six intra-articular resections, and the tumours were in the femur in six cases and the humerus in five. Rates of union, times to union, remodelling patterns and allograft-associated complications were evaluated. No allograft was removed due to a complication. Of the 16 junctional sites, 15 (94%) showed union at a mean of 3.1 months (2 to 5). Remodelling between host and allograft was seen at 14 junctions at a mean of five months (4 to 7). The mean Musculoskeletal Tumor Society score was 26.5 of 30 (88.3%). One case of nonunion and another with screw protrusion required re-operation. Overlapping allografts have the potential to shorten time to union, decrease rates of nonunion and have positive appositional growth effect.

MeSH terms

  • Adolescent
  • Bone Neoplasms / surgery*
  • Bone Transplantation / methods*
  • Child
  • Child, Preschool
  • Female
  • Femur / surgery
  • Follow-Up Studies
  • Humans
  • Humerus / surgery
  • Male
  • Orthopedic Procedures / methods*
  • Transplantation, Homologous / methods
  • Treatment Outcome