AUTOCLAVED TUMORAL BONE-GRAFTS - A REPORT OF 12 CASES

Twelve patients presenting with a bone tumor were operated on using au toclaved bone autografts for reconstruction following carcinologic res ection. According to the Enneking grading system, 6 were high malignan cy tumors (3 osteosarcomas and 3 grade 2 chondrosarcomas), 4 were low grade tumors (1 paraosteal sarcoma, 1 chondrosarcoma, 1 secondary chon drosarcoma, 1 liposarcoma). One was a metastasis from a kidney tumor. The last patient had a femoral osteoid osteoma. Six local recurrences were responsible for 4 reoperations: 2 disarticulations and 2 iterativ e resections. With a 1-6 years range of follow-up (average follow-up 2 ,5 years), osteointegration of autoclaved grafts was studied. Fusion a t the host/graft junction was roentgenographically observed. In three cases, proximal resorption of the humeral graft occurred. Five biopsie s were obtained during reoperation after 1 year, which showed partial revascularization of autoclaved bone autografts. The authors conclude that autoclaved tumoral bone grafts, are reliable and discuss indicati ons. They point out the main contraindication, represented by chemosen sitive bone tumors, in which conservation of the removed tumor is nece ssary to quantify the response to chemotherapy.