MASSIVE INTERCALARY BONE ALLOGRAFTS IN THE TREATMENT OF PRIMARY AND SECONDARY BONE-TUMORS - A REPORT ON 21 CASES

From 1981 to 1993, 21 patients received intercalary bone allografts fo r reconstruction of the extremity after en bloc tumor resection (15 ma lignant and 6 benign tumors). The allografts were collected from multi organ donors and cryopreserved at -70 degrees C. The mean follow-up wa s 4.4 (range 1-13) years. The fate of the grafts was followed by conve ntional radiography, bone scintigraphy. and functional assessment. The overall survival rate of the 7 patients with high-grade malignancies was 86%. Solid union of the graft-host sites in less that 15 months oc curred in 85%. An increased isotope uptake of the graft indicates that incorporation at the osteotomies as well as remodelling is still cont inuing at 9 years after operation. The overall complication rate was 4 3%; 3 patients had two or more complications. Complications were relat ed to the allograft in 6 (infection or fatigue fracture in I and delay ed healing in 4 cases) and to the osteosynthesis in 3 patients. The de finitive results after treatment of complications show that satisfacto ry results have been obtained in all but 2 patients: 62% had excellent , 19% good, and 10% fair results. Intercalary allografts therefore pro vide a valuable solution for large skeletal defects after resection of bone tumors.