ALLOGRAFT RECONSTRUCTION AFTER PROXIMAL TIBIAL RESECTION FOR BONE-TUMORS - AN ANALYSIS OF FUNCTION AND OUTCOME COMPARING ALLOGRAFT AND PROSTHETIC RECONSTRUCTIONS

Seventeen patients (age, 12-63 years; median, 22 years) treated with p roximal tibial allografts were identified. Nine cases were intercalary and eight were osteoarticular allografts. Complications, number of op erations, and oncologic and functional results were reviewed. The func tional results of the allografts were compared with a prior cohort of patients who had endoprosthesis at the same institution by the same su rgeons. There were 14 malignant tumors, two benign aggressive tumors, and one sclerosing osteomyelitis mimicking osteosarcoma. Twelve of 17 patients had complications, the most common being fracture, deformity, and infection. Six patients required more than one procedure, and thr ee had amputations after allograft reconstruction. The ultimate functi on was excellent in three patients, good in seven, fair in six, and po or in one. There were 14 patients with endoprosthetic reconstruction. Wound problems followed by prosthetic loosening were the most common c omplications. Of the eight patients requiring a second procedure, thre e had an amputation. Three had excellent, seven good, and four fair fu nctional results at the final evaluation. No patient in either group h ad a local recurrence. Allograft provides an alternative to endoprosth etic reconstruction; however, the high incidence of complications make s the outcome unpredictable. Allograft or prosthetic reconstruction pr ovides better functional results than amputation without sacrificing o ncologic results.