Complications of irradiated allografts in orthopaedic tumor surgery

Massive structural allografts used for replacement of bone defects after re moval of bone tumors have several complications, including fracture, infect ion, and nonunion. To decrease the rate of infection, irradiation of select ed allografts before their implantation was performed. This study evaluated the complications in patients with these irradiated grafts, Twenty-four pa tients were identified who had received allografts from 1987 through 1991 t hat were irradiated before implantation. The dosage of radiation was betwee n 10 kGy and 30 kGy, The mean length of followup of the patients was 5 year s (range, 2-9 years). These grafts were compared with a control group of gr afts that were not irradiated but were implanted during the same time and u sed for similar diagnostic problems with defects of similar size. The outco mes of the groups differed significantly only in the incidence of allograft fracture. These findings indicate that high-dose irradiation to bone allog rafts is associated with a higher rate of fracture than are similar reconst ructions using nonirradiated allografts.