INFECTION IN MASSIVE BONE ALLOGRAFTS STERILIZED BY RADIATION

Massive bone allografts sterilised by radiation have been used in our hospital since 1985. The 164 consecutive reconstructions which we carr ied out before December 1990 were in equal part for tumour resections and revision arthroplasties associated with major bone defects. The al lografts were used as intercalary or composite graft-prosthesis recons tructions. Fourteen (8.5%) skin sloughs or infections occurred, all bu t one after operations for malignant tumours. The grafts never appeare d to be responsible. Infection after malignant tumour resection most c ommonly occurred at the knee when preoperative radiation had been used . Twenty-five reconstructions were performed in the presence of infect ion, which only recurred in one case. Twelve infections were treated, but 2 other patients died for other reasons within a year One patient had to have an amputation and one had persistent infection. In the oth er cases, the infection healed. Only two debridements alone were succe ssful. Removal of the graft and replacement with antibiotic-loaded cem ent was the most effective treatment.