Reconstruction Using Massive Allografts After Femur Resection Of Osteosarcomas

Objectives:One of the most frequent site for osteosarcoma is femur.Compared with artificial reconstruction,massive allografts reconstruction after resection of osteosarcomas can provide biological union.But massive allografts reconstruction also have many problemsdeficiencies.This study is intended to evaluate the outcome of femoral segmental allograft reconstruction for long diaphyseal defects after tumor resection.Methods:A retrospective study was performed in single center of orthopaedic oncology.All consecutive patients reconstructed with intercalary(whole-circumference)allografts after osteosarcoma resection in the femur during 2005 to 2014 were evaluated.19 patients were followed with a median time of seventeen years(range,7 to 45 years).Results:The median follow-up period was 71 months(range,21 to 123 months).The average length of allografts was 18 cm.Two allografts were removed for local recurrence.There were case of infection,5 cases of fracture,8 cases of recurrence and 5 cases of death.The median time to healing of allograft-host junctions was 20 months(range,10 to 71 months).Allograft length was an important risk factor for union(P=0.05).Conclusion:Our research reveal that femoral segmental allograft construction after massive resection of femoral osteosarcoma have high complication rates,such as nonunion,fractureof allograft.And the union of the junction of allograft needs longer time because the cryopreserved allograft haslower biological activity.The healing time of junctions is also affected by the length of allografts itslef.