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Hemicortical allograft reconstructions demonstrate excellent long-term survival
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Recently published data indicated hemicortical allograft survival was excellent. Additionally, although hemicortial resection was not recommended for high-grade tumors, it was found to be more effective than segmental resection for the treatment of low- and intermediate-grade tumors.
Researchers retrospectively evaluated 111 patients (median age: 28 years) treated with hemicortical resection and allograft reconstruction for a primary bone tumor between 1989 and 2012. Patients were evaluated for mechanical complications and infections, oncological outcome and allograft failure or survival. Follow-up was a minimum duration of 24 months.
The tumor grade was divided into four groups: benign, low-grade malignant, intermediate-grade malignant and high-grade malignant. The researchers used logistic and Cox regression analysis to assess which factors were influential on complication occurrences and time to failure.
Results showed in three patients, the resected specimen demonstrated another diagnosis other than neoplasm. In two out of the three patients, the diagnosis was reactive bone and cartilage formation, whereas in the other patient, a bizarre parosteal osteochondromatous proliferation had occurred. Adamantinoma and parosteal osteosarcoma were the predominant diagnoses, according to the researchers.
There were 11 patients with a benign tumor, whereas 61 patients had low-grade malignant tumors, 22 patients had intermediate-grade malignant tumors and 14 patients had high-grade tumors. According to the researchers, 37 patients had non-oncological complications, with the most common being host bone fracture. Other complications were nonunion infection and allograft fracture.
Complication risks and fractures increased with the degree of cortical resection, according to the researchers. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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