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Allograft fractures revisited.
J I Sorger1, F J Hornicek, M Zavatta
1Orthopaedic Oncology Unit, Massachusetts General Hospital, Boston 02114, USA.
Clinical Orthopaedics and Related Research
|January 12, 2001
Summary
Structural allograft fractures occurred in 17.7% of patients, with longer grafts and certain transplant types showing higher risks. Infection and nonunion significantly impacted outcomes, leading to frequent allograft reconstruction failure.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Oncology
- Biomaterials Science
Background:
- Structural allografts are used in bone reconstruction.
- Allograft fractures represent a significant complication following transplantation.
- Understanding risk factors and outcomes is crucial for improving patient care.
Purpose of the Study:
- To review the incidence, risk factors, and treatment outcomes of structural allograft fractures.
- To identify patient and graft characteristics associated with allograft fracture.
- To evaluate the impact of complications on the success of allograft reconstruction.
Main Methods:
- Retrospective review of 1046 structural allografts implanted between 1974 and 1998.
- Analysis of 185 allograft fractures in 183 patients.
- Evaluation of graft length, transplant type, adjuvant therapy, and associated complications.
Main Results:
- The incidence of structural allograft fracture was 17.7% (185/1046) at a mean of 3.2 years post-transplantation.
- Longer allografts (>15.5 cm) and osteoarticular/arthrodesis transplants were associated with higher fracture rates.
- Infection and nonunion significantly worsened outcomes, with 45.9% of allograft reconstructions failing.
Conclusions:
- Allograft fracture is a common complication with significant morbidity.
- Graft length and transplant type are important considerations for fracture risk.
- Effective management of infection and nonunion is critical to improve allograft reconstruction success.