Resection arthrodesis and osteoarticular allografts reconstruction after resection of primary bone tumors around the knee: Long-term clinical outcomes and prognostic factors for failure of biological reconstruction.

Abstract

The biological reconstruction of the knee with osteoarticular allografts and resection arthrodesis have been reported but there has not yet been a direct comparison between both these procedures. This study aimed to identify the prognostic factors that influence failure of biological reconstruction and compared the results between both procedures. Between 1994 and 2017, we performed 92 limb-sparing procedures using resection arthrodesis (n=53) and osteoarticular allograft reconstruction (n=39) for the management of primary bone tumors around the knee. The minimum follow-up time was 2 years in both groups. The failure rate of reconstruction in the osteoarticular allograft and resection arthrodesis group was 48.7% and 39.6%, respectively (p=0.75). The mean MSTS score in the osteoarticular allograft and resection arthrodesis group was 23.7 and 21.8, respectively (p=0.01). The significant risk factor for failure after biological reconstruction was the administration of chemotherapy (p=0.001; HR=3.39; 95% CI,1.60-7.17). Patients who underwent osteoarticular allograft had a better functional outcome than those who underwent resection arthrodesis reconstruction, but clinical outcomes between the groups were comparable. Chemotherapy is a significant adverse prognostic factor for failure of biological reconstruction.