REIMPLANTATION OF AUTOCLAVED TUMOR BONE IN LIMB SALVAGE SURGERY

This is a prospective clinical study of 7 patients with malignant bone tumours who were treated by resection of the tumour, followed with re construction by reimplantation of the resected autoclaved tumour bone. There were 3 male and 4 female patients between 10 and 36 years of ag e. All the rumours were Stage IIB. Five of the 7 were in the region of the knee joint. Histologically, 5 were osteosarcomas, 1 a recurrent c hondrosarcoma and 1 a recurrent Ewing's sarcoma. All the patients were treated by enbloc resection of the tumour with wide margins. The rese cted length ranged from 13 cm to 28 cm. After removal of soft tissue a nd cartilage, the resected bone segment was autoclaved for 5 min at 13 2 degrees C and 29 pounds per square inch pressure (0.2 mega Pascal). This autoclaved segment of bone was then reimplanted and fixed with an appropriate implant. The average follow-up was 20 months with a range of 14 to 27 months. None of the rumours recurred and at the most rece nt follow-up, all the patients were alive, 6 with no evidence of disea se and one with a lung metastasis. Six of the 7 patients were availabl e for radiological assessment Solid bone union was seen in 4 patients, delayed union in 1 and nonunion in 1. This method of reconstruction u sing an autoclaved tumour bone graft is useful in countries where faci lities for allograft or tumour prostheses are nor available owing to f inancial, technical or sociocultural reasons.