Survival of frozen bone allograft

One case of transplantation of a large osteochondral allograft, with long (8 years) time follow up is reported. Following excision of a benign giant cell tumour the distal part of the left femur, including the joint surfaces, was replaced by a frozen osteochondral allograft. The patient regained function with pain-free weight bearing, and good walking ability. However, the development of a pseudarthrosis between the graft and the host bone necessitated internal fixation and bone grafting two years after the initial surgery. Due to a progressive instability of the knee joint, the graft was replaced by a prosthetic implant eight years after tumor resection. Preoperative scintigraphy showed a high uptake over the grafted area, which corroborated the finding of good vascularization of the graft at surgery. In contrast, histology and fluorochrome uptake of the allograft showed sparse areas of new bone formation. It is concluded that a frozen bone allograft may prove a useful alternative, with good long term results, in the replacement of bone after large resections, in spite of slow and incomplete incorporation.