Intercalary allograft augmented with intramedullarycement and plate fixation is a reliable solution after resectionof a diaphyseal tumour

• Published in: Journal of bone and joint surgery. British volume Vol. 99-B; no. 7; pp. 973 - 978
• Main Authors: Kafchinski, L A, Gundle, K R, Saidi, K, Griffin, A M, Wunder, J S, Ferguson, P C
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone & Joint Surgery 01.07.2017
• ISSN: 2049-4394; 2049-4408
• DOI: 10.1302/0301-620X.99B7.BJJ-2016-0996

AimsIntercalary allografts following resection of a primary diaphysealtumour have high rates of complications and failures. At our institutionintercalary allografts are augmented with intramedullary cementand fixed using compression plating. Our aim was to evaluate theirlong-term outcomes.Patients and MethodsA total of 46 patients underwent reconstruction with an intercalaryallograft between 1989 and 2014. The patients had a mean age of32.8 years (14 to 77). The most common diagnoses were osteosarcoma(n = 16) and chondrosarcoma (n = 9). The location of the tumourswas in the femur in 21, the tibia in 16 and the humerus in nine. Functionwas assessed using the Musculoskeletal Tumor Society (MSTS) scoringsystem and the Toronto Extremity Salvage Score (TESS). The survivalof the graft and the overall survival were assessed using the Kaplan-Meier method.ResultsThe median follow-up was 92 months (4 to 288). The mean MSTS87 score was 29.1 (19 to 35), the mean MSTS 93 score was 82.2 (50to 100) and the mean TESS score was 81.2 (43 to 100). Overall survivalof the allograft was 84.8%. A total of 15 patients (33%) had a complication.Five allografts were revised for complications and one for local recurrence.ConclusionIntercalary allografts augmented with intramedullary cement andcompression plate fixation provide a reliable and durable methodof reconstruction after the excision of a primary diaphyseal bonetumour, with high levels of function and satisfaction. Cite this article: Bone Joint J 2017;99-B:973–8.