Reconstruction using an autograft containing tumour treated by liquid nitrogen

Abstract

We describe a method of reconstruction using tumour-bearing autograft treated by liquid nitrogen in 28 patients. The operative technique consisted of en bloc excision of the tumour, removal of soft tissue, curettage of the tumour, drilling and preparation for internal fixation or prosthetic replacement before incubation for 20 minutes in liquid nitrogen, thawing at room temperature for 15 minutes, thawing in distilled water for ten minutes, and internal fixation with an intramedullary nail, plate or composite use of prosthetic replacement. Bone graft or cement was used to augment bone strength when necessary. The limb function was rated as excellent in 20 patients (71.4%), good in three (10.7%), fair in three (10.7%), and poor in two (7.1%). At the final follow-up six patients had died at a mean of 19.8 months after the operation, while 21 remained free from disease with a mean follow-up of 28.1 months (10 to 54). One patient is alive with disease. Bony union was seen at a mean of 6.7 months after the operation in 26 patients. Complications were encountered in seven patients, including three deep infections, two fractures, and two local recurrences. All were managed successfully. Our results suggest that this is a simple and effective method of biological reconstruction.

Aloenxerto ósseo cortical desvitalizado com nitrogênio líquido - estudo experimental em ovelhas

“…As vantagens do nitrogênio líquido como método de desvitalização extracorpórea foram comprovadas, evidenciando-se o baixo custo, a pequena quantidade de equipamento especializado necessário, a simplicidade da técnica e a dispensa de controle rigoroso da temperatura durante a desvitalização, como já relatado anteriormente (TSUCHIYA et al, 2005;TANZAWA et al, 2008;TSUCHIYA et al, 2010). Outra vantagem confirmada é que, além da remoção do endósteo, periósteo e medula óssea diminuir as reações imunogênicas, o processo de desvitalização com o nitrogênio líquido também tem grande participação nesta função (GUITIERRES et al, 2006), diminuindo o risco de rejeição do enxerto/implante ósseo cortical.…”

Vitreous preservation of articular cartilage from cryoinjury in rabbits

“…We have developed a new reconstruction method using frozen autografts in which the resected tumor-containing bone is immersed into liquid nitrogen (LN 2 ) for 20 min to kill tumor cells, after which the tissue is re-grafted at the same location [33]. An in vitro study verified that our liquid nitrogen treatment method totally devitalized sarcoma tissues such as osteosarcoma [36].…”

Pedicle frozen autograft for limb sparing surgery in a dog with femoral osteosarcoma

“…The soft tissues were protected with gauze and surgical pads. The devitalization protocol was performed according to procedures outlined by TSUCHIYA et al (2005), with the pedicle remaining in liquid nitrogen for 20 minutes, followed by incubation at room temperature for 15 minutes and then in distilled water for 10 minutes. After the devitalization procedure, all surgical instruments and pads were replaced and bone cement was used to refill the devitalized bone marrow cavity; osteosynthesis was then performed with the use of a dynamic compression plate and nine cortical screws (Figure 1).…”

“…These problems and limitations suggested the use of cryosurgery with use of liquid nitrogen, as this procedure does not require specific equipment, is inexpensive, and has been successfully performed in humans (TSUCHIYA et al, 2005;TSUCHIYA et al, 2010;TORIGOE et al, 2012).…”