Low-heat treated autograft versus allograft for intercalary reconstruction of malignant bone tumors

Abstract

Our data suggest that intercalary allograft has better survival and fewer complications than the low-heat treated autograft.

Predictors of complications in heat‐treated autograft reconstruction after intercalary resection for malignant musculoskeletal tumors of the extremity

“…24 Although there were only a few studies regarding the outcomes of intercalary reconstruction with heat-treated autografts, the nonunion rate (38%) and mean time to union (14.0 months) in our series were similar to those in previous reports of intercalary reconstruction with heat-treated autografts. 5,24 Allografts have been widely used for intercalary reconstruction of Additionally, a recent study in the Netherlands reported that the nonunion rate in patients who received intercalary allograft reconstruction was 40% (35 of 87 patients). 4 Based on these results, the nonunion rates reported for allograft reconstruction seemed to be comparable with that in our study using intercalary heat-treated autografts.…”

“…The rates of fracture (4%) and infection (13%) in our series were comparable with those reported previously. Functional outcomes in the present study showed a comparable MSTS score, with a mean value of 76%, to those reported in the literature regarding intercalary reconstruction using heat‐treated autografts or allografts, which ranged from 70% to 90% . The potential risk of local recurrence was a concern related to the recycling technique of the tumor‐bearing bones.…”

“…Jeon et al performed intercalary reconstruction with pasteurized recycled autografts in 21 patients and reported that the rate of nonunion was 23.8% (5 in 21 patients) with a mean duration for bone union of 15.5 months . Han et al reported that the intercalary reconstruction with heat‐treated autografts resulted in a nonunion rate of 42% (11 in 26 junctions), and a mean duration of 15.9 months was required for bone union of host‐graft junctions . Although there were only a few studies regarding the outcomes of intercalary reconstruction with heat‐treated autografts, the nonunion rate (38%) and mean time to union (14.0 months) in our series were similar to those in previous reports of intercalary reconstruction with heat‐treated autografts …”

“…Although they have sufficient initial strength, their strength decreases with time, which subsequently can lead to the development of graft fracture . To avoid these complications, several authors have recommended the combined use of VFG with devitalized autograft or allograft for intercalary reconstruction of skeletal defect . This method makes it possible to enhance the mechanical strength of devitalized grafts with the biological activity of a vascularized bone.…”

“…8,30 To avoid these complications, several authors have recommended the combined use of VFG with devitalized autograft or allograft for intercalary reconstruction of skeletal defect. [17][18][19][20]24,26 This method makes it possible to enhance the mechanical strength of devitalized grafts with the biological activity of a vascularized bone. The devitalized bone graft provides bone stock and initial mechanical stability, and VFG but also enhances neo-vascularization to the dead, grafted bone, which provides osteoblastic and osteoclastic progenitor cells.…”