Massive allograft implantation for limb salvage: a clinical study of 20 cases

From January 1986 to October 1991, the resection of tumorous bone conditions and large allograft implantations were performed in 20 patients at the Department of Orthopaedics and Rehabilitation Medicine, Ramathibodi Hospital, Bangkok, Thailand. The allografts were provided by Bangkok Biomaterial Center at Siriraj Hospital. There were 3 basic groups of grafts: osteoarticular 14, intercalary 3, and allograft-prosthetic composite 3. The diagnosis included 11 osteosarcomas, 1 secondary chondrosarcoma, 1 primary lymphoma, 5 giant cell tumors and 2 metastatic tumors. The average age of the patients was 23.5 years. The average length of the grafts was 14.9 cms. The average follow-up period was 36 months. At the time of evaluation, 70 per cent of the patients had excellent or good results. The complication rate was about 35 per cent but only 15 per cent needed amputation. Rejection of the graft was detected in only 1 patient. The use of large fresh frozen allografts is still necessary in this country because it provides a simple, inexpensive and effective technique of limb salvage in Thailand.