Forearm reconstruction with bone allograft following tumor excision: A series of 10 patients with a mean follow-up of 10 years

Isacker, Tom Van; Barbier, Olivier; Traoré, A.; Mazzeo, F; Delloye, Christian

doi:10.1016/j.otsr.2011.05.017

Cited by 27 publications

(31 citation statements)

References 21 publications

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“…The most frequent complications observed in arthroplasties with osteoarticular allografts are joint instability and articular degeneration [16, 17, 19–25]. None of the five patients in our series developed any form of instability, but recorded incidences in the literature are quite high.…”

Section: Discussionmentioning

confidence: 64%

“…Good to excellent functional outcome can be achieved; nevertheless complications are still common. In contrast to allograft reconstructions at other locations, infection is rare in osteoarticular reconstructions of distal radius [5, 16, 17, 19–25]. Only Szabo et al [20] observed one minor infection (Table 1) [17, 19–22, 24, 25], whilst the incidence of fractures and nonunion reaches up to 25% for both [17, 19–22, 24, 25].…”

Section: Discussionmentioning

confidence: 99%

“…Reconstruction is challenging due to the high functional demands on the hand. Common reconstruction techniques include arthrodesis with different autografts [1, 5–9], prosthetic replacement [10–13], ulnar translocation [5, 14], arthroplasty using (vascularised [8, 15] or nonvascularised [5, 16–18]) autologous fibula graft, or osteoarticular allograft reconstructions (Figure 1) [5, 16, 17, 19–25]. …”

Section: Introductionmentioning

confidence: 99%

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Reconstruction of the Distal Radius following Tumour Resection Using an Osteoarticular Allograft

Rabitsch

Maurer-Ertl

Pirker-Frühauf

et al. 2013

Sarcoma

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Reconstruction of the distal radius following tumour resection is challenging and various techniques are recorded. We retrospectively analysed the outcome of five patients (one male and four females) after reconstruction of the distal radius with osteoarticular allograft, following tumour resection. Mean followup was 32 months (range, 4–121). In three of the five patients the dominant limb was affected. Mean bone resection length was 6.5 centimetres (range, 5–11.5). Two grafts developed nonunion, both successfully treated with autologous bone grafting. No infection, graft fracture, or failure occurred. Mean flexion/extension was 38/60 degrees and mean pronation/supination was 77/77 degrees. The mean Mayo wrist score was 84 and the mean DASH score was 8, both representing a good functional result. Therefore we state the notion that osteoarticular allograft reconstruction of distal radius provides good to excellent functional results.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reconstruction of the Distal Radius following Tumour Resection Using an Osteoarticular Allograft

Rabitsch

Maurer-Ertl

Pirker-Frühauf

et al. 2013

Sarcoma

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“…Van Isacker et al [18] report in a series of forearm allograft similar results, they found that intercalary allograft had fewer complications than osteoarticular allografts, and they had a better functional MSTS score.…”

Section: Discussionmentioning

confidence: 94%

Allograft Reconstruction for the Treatment of Musculoskeletal Tumors of the Upper Extremity

Aponte-Tinao

Ayerza

Múscolo

et al. 2013

Sarcoma

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In comparison with the lower extremity, there is relatively paucity literature reporting survival and clinical results of allograft reconstructions after excision of a bone tumor of the upper extremity. We analyze the survival of allograft reconstructions in the upper extremity and analyze the final functional score according to anatomical site and type of reconstruction. A consecutive series of 70 allograft reconstruction in the upper limb with a mean followup of 5 years was analyzed, 38 osteoarticular allografts, 24 allograft-prosthetic composites, and 8 intercalary allografts. Kaplan-Meier survival analysis of the allografts was performed, with implant revision for any cause and amputation used as the end points. The function evaluation was performed using MSTS functional score. Sixteen patients (23%) had revision surgery for 5 factures, 2 infections, 5 allograft resorptions, and 2 local recurrences. Allograft survival at five years was 79% and 69% at ten years. In the group of patients treated with an osteoarticular allograft the articular surface survival was 90% at five years and 54% at ten years. The limb salvage rate was 98% at five and 10 years. We conclude that articular deterioration and fracture were the most frequent mode of failure in proximal humeral osteoarticular reconstructions and allograft resorption in elbow reconstructions. The best functional score was observed in the intercalary humeral allograft.

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“…24,26 The metatarsal bone and proximal phalanges used in this study were smaller, and therefore revascularization was satisfactory in 100% of cases in the control group and in 50% of cases in the experimental group, based on the quality of the radiological consolidation.…”

Section: Discussionmentioning

confidence: 85%

Digital Joint Reconstruction with Osteotendinous Joint Allograft: Experimental Study in Rats

Iglesias

Cruz-Reyes

Butrón

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Fresh or frozen nonvascularized osteotendinous joint allografts (OTJA) have not been used previously, clinically or experimentally, for metacarpophalangeal joint reconstruction. Therefore, we evaluated the viability of OTJA for metatarsophalangeal joint (MTJ) reconstruction in rats.Methods:In the experimental group of 12 Lewis rats, we reconstructed the MTJ of the third digit of the hindlimb with a fresh, nonvascularized OTJA obtained from the same digit from 12 donor rats. In the control group of 6 Lewis rats, an autologous composite osteotendinous graft of the MTJ of the same digit was obtained and repositioned in situ as an auto-transplant. Weight, pain, edema, dehiscence, and wound infection were evaluated every 24 hours for 30 days postoperatively. At the end of 30 days, we evaluated digit position, flexion and extension, passive mobility, radiological bone healing, and histological grades of rejection.Results:We found no statistically different changes in weight, edema, pain, digit position, or radiological bone healing in either group. No wound dehiscence or infection was seen in any of the rats. Ten degrees of flexion and extension mobility were lost in the control group; the experimental group lost up to 30 degrees (P = 0.009). Histologically, 9 of the experimental group rats (9/12, 75%) showed rejection reactions compared with none of the controls (0%) (P = 0.009).Conclusions:Fresh nonvascularized OTJA caused an immune reaction without exposure of the graft, but with bone resorption. However, the rats maintained digital form and alignment with decreased passive flexion and extension of 10–30 degrees.

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Forearm reconstruction with bone allograft following tumor excision: A series of 10 patients with a mean follow-up of 10 years

Abstract: A bone allograft when available can be considered as one amongst other suitable options for the reconstruction of the forearm skeleton.

Cited by 27 publications

References 21 publications

Reconstruction of the Distal Radius following Tumour Resection Using an Osteoarticular Allograft

Reconstruction of the Distal Radius following Tumour Resection Using an Osteoarticular Allograft

Allograft Reconstruction for the Treatment of Musculoskeletal Tumors of the Upper Extremity

Digital Joint Reconstruction with Osteotendinous Joint Allograft: Experimental Study in Rats

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