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Massive homogenous osteo-articular bone grafts. Long term results
Italian Journal of Orthopaedics and Traumatology
|August 1, 1976
Summary
Massive homogenous bone grafts showed limited success in this long-term review. Researchers recommend these grafts primarily for unicondylar or diaphyseal bone defects, advising alternatives for other cases.
Area of Science:
- Orthopedic Surgery
- Oncology
- Bone Reconstruction
Background:
- Massive homogenous bone grafts were utilized for extensive bone defects between 1967 and 1971.
- Indications included various bone tumors (giant cell, Ewing's, osteosarcoma, chondrosarcoma), trauma, echinococcosis, and aneurysmal bone cysts.
- Some patients opted for grafts over amputation or disarticulation.
Purpose of the Study:
- To evaluate the long-term outcomes of massive homogenous bone grafts.
- To determine the efficacy and ideal indications for these grafts in reconstructive surgery.
Main Methods:
- A retrospective review of thirty cases involving massive homogenous bone grafts (complete or partial diaphyseo-articular).
- Follow-up ranged from three and a half to five years post-operation.
- Analysis of graft incorporation, resorption, and complications.
Main Results:
- Complete graft incorporation was observed in 8 cases, partial in 7, and resorption in 4.
- 15 cases were terminated due to early death, recurrence, infection, or rejection.
- Graft success was higher in unicondylar and diaphyseal substitutions.
Conclusions:
- Massive osteoarticular homogenous grafts are best suited for unicondylar lesions due to better host bone contact and incorporation potential.
- Diaphyseal substitutions also present favorable conditions for osteogenetic invasion.
- For other extensive bone defects, resection arthrodesis or prosthetic replacement are recommended alternatives.