Long-term effect of massive allograft bones implantation on defects:a more than 20 years observation

Objective To explore the long-term effects and complications of large segment allografts in the treatment for bone tumors.Methods A retrospective analysis of 32 consecutive cases,34 to 72 years old,of large segment allograft implantations following resection of bone tumor was conducted.25 cases had aggressive giant-cell tumors of bones,2 had chondrosarcoma and 5 had other bone tumors.The mean length of the grafts was 18.5cm(ranged 10-30cm).15 cases received fixation with common intramedullary nailing,13 with plates,and 4 with screws.Results Followed up from 21 to 28 years(average 24.5 years),30 cases had union and 2 cases did not.Major complications happened in 2 cases,infection in 1 case, fracture in 6 cases,bone absorption in 3 cases,and arthrokleisis in 7 cases.Based on the Mankin system,4 cases had excellent results,21 cases had good results,and 1 case had a fair result.The satisfactory rate was 81.3%.Conclusion Allograft bones implantation is reliable in the long term for repairing the bone deflected in the course of limb salvage following resections of bone tumors.Osteoarthritis is the main complication that affects the long-term quality of life.