The changes in major limb reconstruction as a result of the development of allografts.

Over the past 30 years the author and his colleagues have performed almost 1100 non-pelvic massive cadaveric allografts mostly in the treatment of malignant tumors of bone. The overall results show that 77% of the devices are still functional and competent. The best results were the intercalary grafts (86%) while the poorest were the allograft arthrodeses (61% successful). The complications of fracture and non-union are the principal problems reducing the success rate to 48% and 71% respectively. Primary infection was a major issue but occurred in less than 8% of the cases and reduced the success rate to 72%. Secondary infection following operative procedures to repair fracture or graft non-union occurred in 53 cases and reduced the success rate to less then 30%. No patients died of infection.