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Related Experiment Videos

Infection in massive bone allografts sterilised by radiation

B Loty1, B Tomeno, J Evrard

  • 1Orthopaedic Department, Hôpital Cochin, Paris, France.

International Orthopaedics
|June 1, 1994
PubMed
Summary

Radiation-sterilized bone allografts are effective for major bone defects in tumor resections and revision arthroplasties. While infection risks exist, particularly after tumor surgery, allografts show good outcomes, with antibiotic cement effective for treatment.

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Area of Science:

  • Orthopedic Surgery
  • Oncology
  • Biomaterials Science

Background:

  • Massive bone allografts sterilized by radiation have been utilized since 1985 for complex orthopedic reconstructions.
  • These allografts serve as intercalary or composite graft-prosthesis options for major bone defects.

Purpose of the Study:

  • To evaluate the outcomes of massive bone allografts in 164 consecutive reconstructions performed before December 1990.
  • To assess the incidence and management of complications, specifically skin sloughs and infections, associated with allograft use.

Main Methods:

  • A retrospective review of 164 patients undergoing reconstruction with massive bone allografts.
  • Analysis of graft types (intercalary vs. composite graft-prosthesis) and indications (tumor resection vs. revision arthroplasty).

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  • Detailed examination of complication rates, infection recurrence, and treatment strategies.

    • Main Results:

    • Overall complication rate was 8.5% (14 cases), predominantly skin sloughs or infections, mainly following malignant tumor resections.
    • Infection recurrence was low (1/25) in reconstructions performed in the presence of existing infection.
    • Removal of the allograft and replacement with antibiotic-loaded cement proved the most effective treatment for graft-related infections.

    Conclusions:

    • Massive bone allografts are a viable option for reconstructions involving major bone defects, particularly in revision arthroplasty.
    • While infection is a concern, especially post-malignant tumor resection, allografts themselves were not deemed responsible.
    • Management of infection requires aggressive treatment, with antibiotic-loaded cement demonstrating superior efficacy over debridement alone.