Tertiary cancer center results of sterilized auto-graft prosthetic osteo-articular complex reconstruction following bone tumor resection

Himanshu Rohela , Anupam Lahiri , Irfan Ahmed , Kundan Singh Chufal , Kripa Mishra , Rajan Arora
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Abstract

Background

Bone tumor resections necessitate complex reconstruction methods to maintain limb function and structural integrity. Various approaches, including tumor prostheses and biological reconstructions, offer distinct advantages and disadvantages. The sterilized autograft-prosthetic complex emerges as a promising alternative, combining the benefits of both biological and prosthetic methods.

Objective

This study aimed to evaluate the oncological, radiological, and functional outcomes of sterilized autograft-prosthetic complex reconstructions following bone tumor resections in a tertiary cancer center.

Methods

A retrospective analysis was conducted on 50 patients who underwent osteoarticular reconstruction using liquid nitrogen or ECRT sterilized autograft-prosthetic complexes between 2017 and 2022. Data on patient demographics, sterilization methods, implant specifications, surgical and oncological outcomes, and follow-up were collected and analyzed.

Results

The study cohort comprised 20 pelvic resection patients (Group A) and 30 extremity resection patients (Group B). Mean follow-up was 3 years for Group A and 4 years for Group B. The 5-year graft survival rates were 80 % and 86 % for Groups A and B, respectively. 5 yr OS were 80 % and 83 % for Groups A and B respectively. Complication rates, including infection and implant failure, were higher in Group A compared to Group B, but comparable to published literature. Functional outcomes, assessed using the MSTS system and ISOLS grading satisfactory were in both groups.

Conclusion

Sterilized autograft-prosthetic complex reconstructions demonstrate favorable oncological and functional outcomes in bone tumor resections. While complications such as infection and implant failure remain concerns, this method offers a viable alternative for patients where traditional reconstructions pose challenges.
三级癌症中心对骨肿瘤切除术后消毒自体移植假体骨关节复合体重建的结果
背景骨肿瘤切除术需要复杂的重建方法来维持肢体功能和结构的完整性。包括肿瘤假体和生物重建在内的各种方法各有利弊。本研究旨在评估一家三级癌症中心骨肿瘤切除术后灭菌自体移植物-假体复合体重建的肿瘤学、放射学和功能结果。方法对2017年至2022年间使用液氮或ECRT灭菌自体移植物-假体复合体进行骨关节重建的50例患者进行了回顾性分析。研究收集并分析了患者人口统计学、灭菌方法、植入物规格、手术和肿瘤学结果以及随访等方面的数据。A 组和 B 组的 5 年移植物存活率分别为 80% 和 86%。A组和B组的5年OS分别为80%和83%。与 B 组相比,A 组的感染和植入失败等并发症发生率较高,但与已发表的文献相当。使用 MSTS 系统和 ISOLS 分级评估的功能结果显示,两组均令人满意。虽然感染和植入失败等并发症仍然令人担忧,但这种方法为面临传统重建挑战的患者提供了一种可行的替代方案。
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