Distal Femoral Osteoarticular Allografts: Long-term Survival, But Frequent Complications

Distal Femoral Osteoarticular Allografts: Long-term Survival, But Frequent Complications
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股骨远端同种异体骨关节移植:生存期长,但并发症频繁

DOI:
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发表时间:
2010
影响因子:
4.2
通讯作者:
Parker C. Gibbs
Parker C. Gibbs
中科院分区:
医学2区
文献类型:
--
作者:
Patrick C. Toy;Jeremy R. White;M. Scarborough;W. Enneking;Parker C. Gibbs

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背景同种异体骨关节移植并发症常见,其在股骨远端的长期存活率尚不清楚。因此,骨关节同种异体移植的好处仍然存在争议。问题/问题,因此,我们确定了在骨关节同种异体移植的股骨远端相对于其潜在的长期survival.MethodsWe的并发症的频率回顾性分析了26例骨关节同种异体移植重建股骨远端切除后的恶性或侵袭性良性肿瘤的骨。最低随访时间为15个月(平均,156个月;范围,15-283个月)为所有患者和98个月(平均,191个月;范围,98-283个月)为生存patients.ResultsAt最后一次随访,26个原始同种异体移植物中的16个仍然在地方。5年和10年移植物总存活率分别为69%和63%。关节面5年和10年生存率分别为79%和65%。11名患者保留了原来的骨关节同种异体移植物,没有进行表面重建手术,9名患者转换为同种异体移植物-假体复合物。5例患者转为巨型假体,1例因局部复发截肢。在最后一次随访中,25 26例保留了功能limb.ConclusionsOsteoarticular同种异体骨重建股骨远端可以提供长期的生存和恢复功能,但并发症的风险和他们的身体和金钱的成本为患者是不平凡的。由于缺乏其他解剖部位固有的改善软组织附着的益处,我们认为这种选择最适合于恢复年轻患者的骨量,并期望长期生存。证据等级IV级,治疗研究。有关证据等级的完整描述,请参见作者指南。
BackgroundComplications are frequent with osteoarticular allografts, and their long-term survivorship in the distal femur is unclear. Thus, the benefits of osteoarticular allografting remain controversial.Questions/purposesWe therefore determined the frequency of complications in osteoarticular allografts of the distal femur relative to their potential long-term survival.MethodsWe retrospectively reviewed 26 patients who had osteoarticular allograft reconstruction of the distal femur after resection of a malignant or aggressive benign tumor of bone. The minimum followup was 15 months (average, 156 months; range, 15–283 months) for all patients and 98 months (average, 191 months; range, 98–283 months) for the surviving patients.ResultsAt last followup, 16 of the 26 original allografts were still in place. The overall 5-year and 10-year allograft survival rates were 69% and 63%, respectively. The 5-year and 10-year survival rates of the joint surface were 79% and 65%, respectively. Eleven patients retained their original osteoarticular allograft without a resurfacing procedure, and nine had been converted to allograft-prosthetic composites. Five patients were converted to megaprostheses and one had an amputation for local recurrence. At last followup, 25 of 26 patients retained a functional limb.ConclusionsOsteoarticular allograft reconstructions of the distal femur can provide long term survival and restore function but the risk of complications and their physical and monetary costs for patients are not trivial. Lacking the benefit of improved soft tissue attachments inherent in other anatomic sites, we believe this option is most appropriate for restoring bone stock in young patients with expectations of long-term survival.Level of EvidenceLevel IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
DOI: --
发表时间: 1987
期刊: The Orthopedic clinics of North America
影响因子: --
作者:
Mankin,HJ;Gebhardt,MC;Tomford,WW
通讯作者: Tomford,WW
DOI: 10.2106/00004623-199311000-00011
发表时间: 1993-11-01
影响因子: 5.3
作者:
THOMPSON, RC;PICKVANCE, EA;GARRY, D
通讯作者: GARRY, D