Autoclaved tumor bone for reconstruction: an alternative in developing countries.

The options for reconstruction after excision of skeletal tumors include reimplanting the autoclaved tumor-bearing bone. We asked whether such bone will survive and unite with normal bone and whether the local tumor recurrence rate increases after its use. We ascertained the functional outcome (Musculoskeletal Tumor Society score) and complications in 19 patients. After wide excision, the bony segment was autoclaved at 120 degrees for 10 minutes and reimplanted at the original defect with intramedullary nails and compression plates. Twelve of our 19 patients were available for followup. The autoclaved segment united with the normal bone in 11 of the 12 patients. No patients had fracture or resorption of the autoclaved segment. Two patients had local tumor recurrence in nearby soft tissues, apparently unrelated to the autoclaved bone. The mean functional score was 70%. Complications included fatigue failure of the nail in one patient, superficial infection in three patients, and deep infection in two patients. Reconstruction with autoclaved tumor-bearing bone is a simple and effective tool in limb salvage. This technique is a cost-effective alternative for developing countries circumventing complications of prosthetic and allograft reconstruction.