Pasteurized autograft-prosthesis composite for reconstruction of proximal tibia in 13 sarcoma patients.

BACKGROUND: The purpose of this study is to ascertain the survival of the pasteurized autograft-prosthesis composite and functional outcome of this procedure, and to evaluate the complications including nonunion, infection, loosening, bony resorption, and fracture.
METHODS: We retrospectively reviewed 13 proximal tibial sarcoma patients who underwent tibia reconstructions with using a pasteurized autograft-prosthesis between 1993 and 2003.
RESULTS: Four patients underwent removal of the composite with a minimum follow-up of 11 months (average: 43 months, range: 11-75 months). The survival rate of the 13 composites, as calculated by the Kaplan-Meier method, was 76.9% at 5 years. The primary cause of removing the composite was infection in three patients and loosening in one patient. The average MSTS functional score of 11 patients was 23.6 +/- 3.3 (79%). Nonunion was identified in four patients, while infection developed in three patients. Loosening of the stem and resorption of the pasteurized bone was detected in one case each. No patient developed fracture of autograft.
CONCLUSIONS: Our data suggest that the pasteurized autograft-prosthesis has comparable functional outcome and complication rates as other methods, such as endoprosthesis and allograft-prosthetic composite and it offers a reconstructive option for surgeons who do not have access to large allograft banks.