Repairing bone and joint defect after tumor excision with allograft/prosthetic composite arthroplasty

Abstract

To assess the results and complications of allograft/prosthetic composite arthroplasty for the bone and joint defect after tumor resection. Allograft/prosthetic composite arthroplasty included proximal femoral allograft with total hip arthroplasty (12 cases), distal femoral allograft with total knee arthroplasty (10 cases), and proximal tibial allograft with total knee arthroplasty (3 cases). The bone cement was used to fix the prosthesis and allograft-host bone. Before and after operation, 10 patients with osteosarcoma and 4 patients with malignant fibrous histiocytoma received high-dose chemotherapy for 6 cycles. The mean duration of follow-up was 64 months (36 to 112 months). Three patients died within 37 months. The remaining were alive with tumor-free. There were no dislocation or loose of the prosthesis. Two greater trochanters of the allogenous femur were partially absorbed. Synostosis was found at the allograft-host conjunction of all patients. Using the Enneking functional evaluation system, the mean postoperative score for all patients was 23.4 with a range from 17-27. Allograft/prosthetic composite arthroplasty has the advantages of both techniques and can meet the functional need of patients.