Clinical and functional outcomes of tibial intercalary allografts after tumor resection

Reconstruction after intercalary resection of the tibia is demanding due to subcutaneous location, poor vascularity of the tibia, and high infection rate. The purpose of this study was to evaluate the survivorship, complications, and functional outcome of intercalary tibial allograft reconstructions following tumor resections. Intercalary tibia segmental allografts were implanted in 26 consecutive patients after segmental resections. Patients were followed for an average of 6 years. Allograft survival was determined with the Kaplan-Meier method. Patient function was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system. Survivorship was 84% (95% confidence interval [CI], 98%-70%) at 5 years and 79% (95% CI, 63%-95%) at 10 years. Allografts were removed in 5 patients due to 3 infections and 2 local recurrences. Two patients showed diaphyseal nonunion, and 3 patients underwent an incomplete fracture; no allografts were removed in these patients. Average MSTS functional score was 29 points (range, 27-30 points). Despite the incidence of complications, this analysis showed an acceptable survivor-ship with excellent functional scores. The use of intercalary allograft has a place in the reconstruction of a segmental defect created by the resection of a tumor in the diaphyseal or metaphyseal portion of the tibia.