[Long-term outcome of large bone and osteochondral allografts]

Since 1978 the Marseille Bone Tissue Bank has stored 7466 specimens. Of these, 578 were large allografts, of which 529 have so far been used. The grafts are stored in liquid nitrogen with a cryopreserver, and are not sterilized by irradiation. They have been used to replace lost tissue after tumor excision, trauma, and repeated reconstructive surgery. Three hundred and thirteen patients were operated on between 1983 and 1998, and good integration was achieved in 82 % of cases. Immunological complications occurred in 14 % of cases. They were often confused with non microbial sepsis and responded well to immunosuppressive treatment, even though the fluid surrounding the graft sometimes fistulised to the skin. In 4.2 % of cases the graft had to be replaced, and in 6.4 % of cases a joint prosthesis had to be used.