Reconstruction with pasteurized autograft for distal tibial tumor

Abstract

Primary malignant tumors of the distal tibia are rare. With advances in various treatment modalities, limb salvage for tumors of the distal tibia has been indicated for selected cases. This study examined whether the results of a pasteurized autologous bone graft are comparable to other reconstruction methods with regard to the graft survival and the functional outcome. Between 1992 and 2003, nine patients with malignant tumors of the distal tibia were subjected to the reconstruction with a recycled pasteurized autograft. The ultimate graft survival, union time, complications, and functional results were analyzed retrospectively. One out of the nine autografts was removed after 15 months, due to non-union. Seven complications occurred in six patients, which included superficial infections (two cases), deep infections (one case), non-union (two cases), and fracture (two cases). None of the patients required a secondary below the knee amputation during the follow-up period. The average musculoskeletal tumor society (MSTS) functional score was 26/30 (86.7%). The reconstruction with a pasteurized autograft is a simple and easily method for treating distal tibial malignancies. Moreover, vascularized fibula transfer might be considered a good ancillary procedure for resolving graft-related complications.