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Published on: September 9, 2020
Frozen inactivated autograft replantation for bone and soft tissue sarcomas
Zhichao Tian1, Shuping Dong1, Yang Yang2
1Department of Bone and Soft Tissue, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China.
Background:
The frozen inactivation of autologous tumor bones using liquid nitrogen is an important surgical method for limb salvage in patients with sarcoma. At present, there are few research reports related to frozen inactivated autograft replantation.
Methods:
In this study, we retrospectively collected the clinical data of patients with bone and soft tissue sarcoma treated with liquid nitrogen-frozen inactivated tumor bone replantation, and analyzed the safety and efficacy of this surgical method. The healing status of the frozen inactivated autografts was evaluated using the International Society of Limb Salvage (ISOLS) scoring system. Functional status of patients was assessed using the Musculoskeletal Tumor Society (MSTS) scale.
Results:
This study included 43 patients. The average length of the bone defect after tumor resection is 16.9 cm (range 6.3-35.3 cm). Patients with autograft not including the knee joint surface had significantly better healing outcomes (ISOLS scores) (80.6% ± 15% vs 28.2% ± 4.9%, P<0.001) and limb function (MSTS score) (87% ± 11.6% vs 27.2% ± 4.4%, P<0.001) than patients with autografts including the knee joint surface. The healing time of the end of inactivated autografts near the metaphyseal was significantly shorter than that of the end far away from the metaphyseal (9.8 ± 6.3 months vs 14.9 ± 6.3 months, P=0.0149). One patient had local recurrence, one had an autograft infection, five (all of whom had an autograft including the knee joint surface) had joint deformities, and seven had bone non-union.
Conclusion:
Frozen inactivated autologous tumor bone replantation is safe and results in good bone healing. But this method is not suitable for patients with autograft involving the knee joint surface.
Insights
Liquid nitrogen-frozen inactivated autologous tumor bone replantation is a safe surgical option for sarcoma patients, showing good bone healing. However, it is not recommended for grafts involving the knee joint surface due to poorer outcomes.
Area of Science:
- Orthopedic Surgery
- Skeletal Oncology
- Limb Salvage Procedures
Background:
- Frozen inactivation of autologous tumor bone using liquid nitrogen is a key technique for limb salvage in sarcoma patients.
- Limited research exists on frozen inactivated autograft replantation outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of liquid nitrogen-frozen inactivated tumor bone replantation for sarcoma.
- To analyze healing and functional outcomes using established scoring systems.
Main Methods:
- Retrospective analysis of clinical data from 43 sarcoma patients.
- Assessment of autograft healing via the International Society of Limb Salvage (ISOLS) system.
- Evaluation of limb function using the Musculoskeletal Tumor Society (MSTS) scale.
Main Results:
- Patients with autografts excluding the knee joint had significantly better ISOLS (80.6% ± 15%) and MSTS (87% ± 11.6%) scores compared to those including the knee (28.2% ± 4.9% and 27.2% ± 4.4%, respectively).
- Metaphyseal autograft ends healed significantly faster (9.8 ± 6.3 months) than non-metaphyseal ends (14.9 ± 6.3 months).
- Complications included local recurrence (1), infection (1), joint deformities (5), and bone non-union (7).
Conclusions:
- Liquid nitrogen-frozen inactivated autologous tumor bone replantation demonstrates safety and promotes effective bone healing.
- This technique is not advisable for autografts that include the knee joint surface due to compromised outcomes.
