Allograft ankle arthrodesis: a limb salvage technique for distal tibial tumors

Allograft ankle arthrodesis using a retrograde intramedullary tibial nail is a new strategy in limb salvage for treatment of distal intraarticular tibial tumors. After tumor resection, the ankle is reconstructed using an intercalary allograft and retrograde intramedullary fixation. We retrospectively reviewed nine consecutive patients with intraarticular resection of distal tibial tumors who had allograft ankle arthrodesis reconstruction between April 1994 and August 2000. Patient charts were reviewed for: (1) local recurrence, new metastases, and survival; (2) Musculoskeletal Tumor Society score; and (3) complications or reoperations or both. Only one of nine patients had a local recurrence. Eight of nine patients achieved independent ambulation. Eight of nine patients had a Musculoskeletal Tumor Society score greater than 73%. Six of nine patients required nine additional operations. No patients required flap coverage. There were no superficial or deep infections. Allograft ankle arthrodesis is a new alternative in limb salvage for distal tibial tumors. It has oncologic outcomes (rate of local recurrence, new metastases, and survival from time of diagnosis) and functional outcomes (Musculoskeletal Tumor Society score and rates of reoperation) comparable to previously reported and accepted methods of limb salvage.

Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.