Bone Tumour Sterilization Using Pasteurization for Autologous Bone Reconstruction

Abstract

Primary bone malignancies have incidence of 0.2% among all malignant tumours and 15% in all primary tumours. The commonest primary bone malignancy is osteosarcoma which the frequency had increased by 0.3% yearly over the last decade. Improvement in treatment of bone sarcoma by multidisplinary protocols involving diagnostic imaging, chemotherapy and surgical technique has improved the survival rate from 20% to 80%, hence paradigm of treatment shifted from amputation to limb preserving surgery. Bone reconstruction techniques varies from prosthetic replacement, allograft and bone autograft method. Bone autograft method needed sterilizing technique to devitalised tumour cells and pasteurization is a good option in maintaining its biomorphogenic properties when heated to 60°C -70°C for 30-40 minutes. This article will be discussing on histopathology findings, biomechanical outcome and clinical outcome of bone reconstruction using pasteurized autograft bone method. The advantages of pasteurization include less risk of disease transmission, no risk of allogenic immunogenicity, readily available, simple, less expensive and satisfactory bone remodelling. However, in certain cases it also shows deteriorating outcome in long term follow up due to issues with graft fracture, infection and resorption.