Allograft prosthetic composite replacement for bone tumors

Limb salvage for bone tumors has become the standard method of treatment. This technique involves removal of large segments of bone, most commonly around the hip and knee. Various types of reconstructive options are currently available, including osteoarticular allograft arthroplasty, modular oncology prosthetic arthroplasty, allograft prosthetic composite (APC) arthroplasty, and arthrodesis. Compared to other techniques, APC arthroplasty has many advantages, including restoration of bone stock, customization with conventional implant components, soft tissue attachment of tendons and ligaments, and preservation of the medullary canal of the host bone. The disadvantages of this technique include slow healing in the presence of chemotherapy, the possibility of disease transmission, and availability. The technique is suited either for aggressive benign tumors or for low-grade sarcomas where chemotherapy is not necessary. Further, it represents a good alternative for a failed modular oncology prosthesis, and also for the failed osteoarticular allograft because it restores bone stock. Good functional results have been reported with APC replacements, but long-term follow-up is needed to determine their durability.