Replacement of the distal femur and proximal tibia with frozen allografts

Eighty-eight osteoarticular distal femoral allografts and 68 proximal tibial allografts have been transplanted at the authors' institution from 1958 to 1970. These allografts were used in limb-sparing operations performed after the diagnosis of benign or malignant tumors. All allografts were preserved by freezing to -70 degrees or -30 degrees. Allograft fixation technique depended either on press fitting of the allograft host junction or on quadrangular titanium intramedullary rods. The most prevalent long-term complication was the time-dependent development of destructive arthrosis. After excluding patients with tumor failures (8.3%) and those with failures caused by infections, amputations, or allograft removal without subsequent replacement (5%), 135 patients remained. In this group of patients, after treatment of complications, good or excellent results were obtained in 31% of patients, and fair results in 45% of patients. In the latter group, significant limitation of knee motion existed. The remainder (24%) had either complete limitation of knee motion or had to rely on orthopaedic bracing.