Kuan-Lin Chen1,2,3, Chao-Ming Chen1,2,3,4, Cheng-Fong Chen1,2,3, Yu-Chi Cheng5, Yu-Kuan Lin1,2,3,6, Shang-Wen Tsai1,2,3,4, Tain-Hsiung Chen1,2, Po-Kuei Wu7,8,9,10, Wei-Ming Chen1,2,3. 1. Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC. 2. Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC. 3. Orthopaedic Department School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112, Taiwan ROC. 4. Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Taipei City, 112, Taiwan ROC. 5. Department of Radiology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC. 6. Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112, Taiwan (ROC). 7. Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC. drwuvgh@gmail.com. 8. Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 112, Taiwan ROC. drwuvgh@gmail.com. 9. Orthopaedic Department School of Medicine, National Yang Ming Chiao Tung University, No.155, Sec.2, Linong Street, Taipei City, 112, Taiwan ROC. drwuvgh@gmail.com. 10. Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Taipei City, 112, Taiwan ROC. drwuvgh@gmail.com.
Abstract
PURPOSE: This retrospective, single-centre study compares the clinical and radiographic outcomes of limb reconstruction using recycled autografts to that using allografts. METHODS: Patients with histopathologically verified high-grade osteosarcoma treated with wide bone resection and limb reconstruction using allografts or recycled autografts from January 1998 through December 2012 were retrospectively screened for enrolment eligibility. The final study cohort included 255 patients (allograft, 91; recycled autograft, 164). Data regarding post-operative complications, salvage treatment, and graft survival were collected. A modified International Society of Limb Salvage classification system was used to evaluate the radiographic findings. RESULTS: The time to graft-host union did not differ significantly between the two graft types. Patients receiving recycled autografts had fewer complications compared than did those receiving allografts (recycled autografts vs. allograft: structural failure, 4.3 vs. 13.2%; late infection, 2.4 vs. 7.7%; all p < 0.05). Complications occurred most frequently during the first three years after surgery, and the majority were manageable. The five year limb survival rate did not differ significantly between the two graft types (91.3 vs. 94.0%; p = 0.752). No local oncological recurrence was observed within the recycled autografts. CONCLUSION: Recycled autografts and allografts are feasible options for biological limb reconstructions in terms of complications and graft survival after wide resection of osteosarcoma.
PURPOSE: This retrospective, single-centre study compares the clinical and radiographic outcomes of limb reconstruction using recycled autografts to that using allografts. METHODS: Patients with histopathologically verified high-grade osteosarcoma treated with wide bone resection and limb reconstruction using allografts or recycled autografts from January 1998 through December 2012 were retrospectively screened for enrolment eligibility. The final study cohort included 255 patients (allograft, 91; recycled autograft, 164). Data regarding post-operative complications, salvage treatment, and graft survival were collected. A modified International Society of Limb Salvage classification system was used to evaluate the radiographic findings. RESULTS: The time to graft-host union did not differ significantly between the two graft types. Patients receiving recycled autografts had fewer complications compared than did those receiving allografts (recycled autografts vs. allograft: structural failure, 4.3 vs. 13.2%; late infection, 2.4 vs. 7.7%; all p < 0.05). Complications occurred most frequently during the first three years after surgery, and the majority were manageable. The five year limb survival rate did not differ significantly between the two graft types (91.3 vs. 94.0%; p = 0.752). No local oncological recurrence was observed within the recycled autografts. CONCLUSION: Recycled autografts and allografts are feasible options for biological limb reconstructions in terms of complications and graft survival after wide resection of osteosarcoma.
Authors: Akihiko Takeuchi; Valerae O Lewis; Robert L Satcher; Bryan S Moon; Patrick P Lin Journal: Clin Orthop Relat Res Date: 2014-07-01 Impact factor: 4.176