Acta Ortopédica Mexicana

López-Martínez JJ, García-Sandoval PP, Fernández-Hernández JA, Valcárcel-Díaz A
Functionality and osteointegration of bone allografts in long bone osteosarcomas
Acta Ortop Mex 2012; 26 (1)

Language: Español
References: 27
Page: 30-34
PDF: 91.82 Kb.

[Fulltext - PDF]

ABSTRACT

In patients undergoing long bone resection for osteosarcoma the use of bone allografts is a treatment option. How do they behave functionally and what is their long term osteointegration? Material and methods: A retrospective, observational, longitudinal study was conducted to obtain clinical and radiologic data of the sample composed of a group of 15 patients with a diagnosis of limb osteosarcoma treated at our hospital with structural bone allografts. The Mankin and ISOLS (International Symposium on Limb Salvage) scales were applied to assess allograft functionality and osteointegration, respectively, from 1993 to 2006. Results: Functional results were as follows: excellent, 10 patients (66.6%); good, one patient (6.6%), and poor, 4 patients (26%). The osteointegration assessment reported excellent results in 77% of cases at 18 months and in 87% at 2 years. Surgical wound infection was reported as a complication in only 2 patients (13.3%). Conclusions: Functionality and osteointegration in patients undergoing conservative surgery with bone allografts are excellent in most cases, and this is the technique of choice for the treatment of long bone osteosarcomas.


Key words: osteosarcoma, graft, neoplasms.


REFERENCES

  1. Espinosa CV: Bone allografts in orthopedic surgery. Patología del aparato locomotor 2004; 2(4): 263-87.

  2. Garza PC, Mendoza LOF, Galván MR, Briseño NRA, Álvarez LE: Banco de hueso y tejidos: Alta tecnología disponible para los ortopedistas mexicanos. Acta Ortop Mex 2004; 18(6): 320-5.

  3. Sanchís OV: El banco de huesos del Hospital Provincial de Madrid. Acta Ortop Traum Ibérica 1953; 1: 3-12.

  4. San-Julian M, Amillo S, Cañadell J: Allografts in malignant bone tumors. In: Czitrom and Winkler (Eds.). Orthopaedic Allograft Surgery. Springer Verlag, New York-Wien. 1996: 157-63.

  5. San-Julian M, Cañadell J: Fractures in massive bone allografts for limb preserving operations. Int Orthop 1998; 22: 32-6.

  6. Chao EY, Ivins JC (Eds): Tumor prosthesis for bone and joint reconstruction. Stuttgart-Nueva York, G Thieme Verlag, 1983.

  7. Friedlaender GE: Current concepts review bone banking. J Bone Joint Surg 1982; 64(A): 307-11.

  8. Mankin HJ, Doppelt SH, Sullevan TR, Tomford WW: Osteoarticular and intercalary allograft transplantation in the management of malignant tumors of bone. Cancer 1982; 50: 613-30.

  9. Brown KLB: Graft radiographic evaluation. International Symposium of Limb Salvage, 1991.

  10. Larsson SE, Lorentzon R: The incidence of malignant primary bone tumors in relation to age sex and site: a study of osteogenic sarcoma, chondrosarcoma and Ewing´s sarcoma diagnosed in Sweden from 1958 to 1968. J Bone Joint Surg (Br) 1974; 56: 534-40.

  11. Landis SH, Murray T, Bolden S, Wingo PA: Cancer statistics, 1999. CA Cancer J Clin 1999; 49(1): 18-31.

  12. Capanna R, Donati D, Martini A, et al: Nonunion in allograft surgery. En: Pho RWH. Proceedings of the Seventh International Symposium of Limb Salvage, Singapur, 1993: 193-6.

  13. Malinin TI, Couceiro J, et al. Cirugía de preservación de la extremidad en cirugía ortopédica oncológica. Revista de Ortopedia y Traumatología 1998; 42: 324-9.

  14. Muscolo L. Resultados a largo plazo de los trasplantes óseos masivos. Trasplantes 2 1995; 1: 1225.

  15. Muscolo L, Kawai S, Ray RD: Cellular and humoral inmune response analysis of bone-allografted rates. J Bone Joint Surg (Am) 1976; 58: 826-32.

  16. M. San Julián, Valentí A: Trasplante óseo. Anales Sis San Navarra 2006; 29 (supl 2).

  17. Hornicek FJ, Gebhardt MC, Tomford WW, Sorger JI, Zavatta M, Mankin HJ: Factors affecting nonunion of the allograft-host junction. Clin Orthop 2001; 382: 87-98.

  18. Fox EJ, Hau MA, Gebhardt MC, Hornicek FJ, Tomford WW, Mankin HJ: Long-term followup of proximal femoral allografts. Clin Orthop Related Res 2002; 397: 106-13.

  19. Okada K, Unni KK, Swee RG, et al: High grade surface osteosarcoma: a clinicopathologic study of 46 cases. Cancer 85 1999; 5: 1044-54.

  20. Parrish FF: Allograft replacement of part of the end of a long bone following excision of a tumor. Report of twenty-one cases. J Bone Joint Surg 1973; 55A: 1-22.

  21. Marigil MA, Pardo-Mindán FJ: Tumores óseos. En: Pardo Mindán FJ (eds). Anatomía patológica General y Especial de las neoplasias. Barcelona: Editorial científico-médica. 1989; 20: 267-71.

  22. Donati D, Di Liddo M, Zavatta M: Reconstrucción con aloinjerto óseo masivo en el osteosarcoma de alto grado. Clin Orthop 2001; 3: 46-54.

  23. Mankin HJ, Ortiz EJ, Bibiloni J: Resultados a largo plazo y futuro de los trasplantes con aloinjertos óseos. Rev Ortop Traumatol 1996; 40: 556-61.

  24. Garbuz DS, Masri BA, Czitrom AA: Biology of allografting. Orthop Clin North Am 1988; 29: 199-204.

  25. Horowitz MC, Friedlander GE: Inmunologic aspects of bone transplantation. A rationale for future studies. Orthop Clin North Am 1987; 18: 227-33.

  26. Czitrom AA, Axelrod TS, Fernandes B: Antigen presenting cells and bone allotransplantation. Clin Orthop 1985: 27-31.

  27. Dion N, Sim FH: The use of allografts in musculoskeletal oncology. J Bone Joint Surg Am 2002; 84A: 644-54.