OSTEOARTICULAR ALLOGRAFTS FOR RECONSTRUCTION AFTER RESECTION OF A MUSCULOSKELETAL TUMOR IN THE PROXIMAL END OF THE TIBIA

An osteoarticular allograft was used to reconstruct a skeletal deficie ncy in sixteen patients after resection of a tumor in the proximal end of the tibia. The status of each allograft and the condition of each involved limb were evaluated an average of nine years (range, six to f ourteen years) postoperatively. The status of the allograft was evalua ted according to the survival of the allograft and the occurrence of c omplications. Of the original sixteen allografts, seven were removed: six, between two and five years after the reconstruction and one, seve n years after the reconstruction. A second reconstruction with use of an allograft was performed in five of the seven patients. Fifteen comp lications occurred in association with eleven of the original sixteen allografts. These included fracture of the allograft (five patients), subchondral collapse (five patients), infection (two patients), non-un ion (two patients), and instability of the joint (one patient). At the latest follow-up examination, nine patients had retained the original allograft, five had had a second allograft procedure, and two had had an above-the-knee amputation. The most recent result was rated excell ent or good in eleven patients and fair or a failure in five, with use of the system of Mankin et al. It was rated good or excellent in nine patients and fair, poor, or a failure in six, and it was not rated in one patient who had died, according to the system of the Musculoskele tal Tumor Society. Finally, the result was rated good or excellent in twelve patients and a failure in three, and it was not rated in the pa tient who had died, on the basis of the system of The Hospital for Spe cial Surgery.