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Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma
Jun Manabe1, Adel Refaat Ahmed, Noriyoshi Kawaguchi
1Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. manabe@jfcr.or.jp
Clinical Orthopaedics and Related Research
|March 17, 2004
Summary
Pasteurization of bone offers a viable option for skeletal reconstruction in bone tumor surgery, showing good graft incorporation and functional outcomes. This method avoids infection and allogeneic reactions, making it a promising alternative for patients.
Area of Science:
- Orthopedic Surgery
- Oncology
- Biomaterials Science
Background:
- Skeletal reconstruction is crucial after bone tumor resection.
- Autologous bone grafts are commonly used, but processing methods vary.
- Pasteurization is an alternative to autoclaving and boiling for bone graft preparation.
Purpose of the Study:
- To evaluate the efficacy and safety of pasteurized autologous bone grafts for skeletal reconstruction in patients with malignant bone tumors.
- To assess graft incorporation, viability, functional outcomes, and complications.
Main Methods:
- A study group of 25 patients (23 with primary malignant bone tumors, 2 with soft tissue sarcoma invading bone) underwent reconstruction with pasteurized autologous bone grafts.
- Radiographic evaluation used the International Society of Limb Salvage graft evaluation method.
- Bone scintigraphy assessed graft viability.
- Functional results were evaluated using the Musculoskeletal Tumor Society system.
Main Results:
- Complete graft incorporation was observed in 60% of patients, with partial incorporation in 32%.
- Bone scintigraphy indicated graft viability in 17 of 22 evaluated patients starting around 6 months postoperatively.
- The mean functional rating was 86%, with 18 patients disease-free at follow-up (mean 52 months).
- Major complications included fracture (12%) and infection (20%); no local recurrence was detected.
Conclusions:
- Pasteurization of bone is a potentially useful technique for reconstruction after malignant bone tumor resection.
- Extracorporeal pasteurization offers advantages such as convenience, prevention of intraspecies infection, and avoidance of allogeneic reactions.
- Satisfactory bone remodeling and functional outcomes support pasteurization as a viable option.