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International Orthopaedics
Published in: International Orthopaedics 6/2011

01-06-2011 | Original Paper

Extracorporeally irradiated autografts for the treatment of bone tumours: tips and tricks

Authors: Bart Poffyn, Gwen Sys, Alexander Mulliez, Georges Van Maele, Luc Van Hoorebeke, Ramses Forsyth, Dirk Uyttendaele

Published in: International Orthopaedics | Issue 6/2011

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Abstract

We retrospectively reviewed 107 patients with 108 malignant or locally aggressive bone tumours treated between 1978 and 2009 by extracorporeal irradiation with 300 Gy to eradicate the tumour, and reimplantation of the bone as an orthotopic autograft. Patient subgroups were defined according to resection type. We describe the local recurrence rate, the graft infection rate and the factors affecting graft healing and graft survival. No local recurrences were detected in the irradiated grafts. At five-year follow-up, graft healing had occurred in 64% of patients, providing a stable and lasting reconstruction. For various reasons, 11% of grafts were removed, although no single factor was predictive of failure. All patient subgroups had comparable results. Early infection predicted the development of pseudarthrosis. Pelvic reconstructions had a worse graft survival. Rigid fixation and bridging of the graft appeared to be important technical points.
Literature
1.
Pakos EE, Nearchou AD, Grimer RJ, Koumoullis HD, Abudu A et al (2009) Prognostic factors and outcomes for osteosarcoma: An international collaboration. Eur J Cancer 45:2367–2375PubMedCrossRef
2.
Langlais F, Belot N, Ropars M, Lambotte JC, Thomazeau H (2006) The long-term results of press-fit cemented stems in total knee prostheses. J Bone Joint Surg Br 88:1022–1026PubMed
3.
Myers GJC, Abudu AT, Carter SR, Tillman RM, Grimer RJ (2007) Endoprosthetic replacement of the distal femur for bone tumours: long-term results. J Bone Joint Surg Br 89:521–526PubMedCrossRef
4.
Kinkel S, Lehner B, Kleinhans JA, Jakubowitz E, Ewerbeck V, Heisel C (2010) Medium to long-term results after reconstruction of bone defects at the knee with tumor endoprostheses. J Surg Oncol 101:166–169PubMed
5.
Griffin AM, Parsons JA, Davis AM, Bell RS, Wunder JS (2005) Uncemented tumor endoprostheses at the knee: root causes of failure. Clin Orthop Relat Res 438:71–79PubMedCrossRef
6.
Sharma S, Turcotte RE, Isler MH, Wong C (2007) Experience with cemented large segment endoprostheses for tumors. Clin Orthop Relat Res 459:54–59PubMedCrossRef
7.
Shin DS, Weber KL, Chao EYS, An KN, Sim FH (1999) Reoperation for failed prosthetic replacement used for limb salvage. Clin Orthop Relat Res 358:53–63PubMedCrossRef
8.
Lietman SA, Tomford WW, Gebhardt MC, Springfield DS, Mankin HJ (2000) Complications of irradiated allografts in orthopaedic tumor surgery. Clin Orthop Relat Res 375:214–217PubMedCrossRef
9.
Mankin HJ, Doppelt S, Tomford W (1983) Clinical experience with allograft implantation. The first 10 years. Clin Orthop Relat Res 174:69–86PubMed
10.
Sanjay BKS, Moreau PG, Younge DA (1997) Reimplantation of autoclaved tumour bone in limb salvage surgery. Int Orthop 21:291–297PubMedCrossRef
11.
Asada N, Tsuchiya H, Kitaoka K, Mori Y, Tomita K (1997) Massive autoclaved allografts and autografts for limb salvage surgery. A 1–8 year follow-up of 23 patients. Acta Orthop Scand 68:392–395PubMedCrossRef
12.
Harrington KD, Johnston JO, Kaufer HN, Luck JV, Moore TM (1986) Limb salvage and prosthetic joint reconstruction for low-grade and selected high-grade sarcomas of bone after wide resection and replacement by autoclaved autogeneic grafts. Clin Orthop Relat Res 211:180–214PubMed
13.
Wheeler DL, Enneking WF (2005) Allograft bone decreases in strength in vivo over time. Clin Orthop Relat Res 435:36–42PubMedCrossRef
14.
Friedlaender GE (1991) Bone allografts: the biological consequences of immunological events. J Bone Joint Surg Am 73:1119–1122PubMed
15.
Tomford WW, Thongphasuk J, Mankin HJ, Ferraro MJ (1990) Frozen musculoskeletal allografts: a study of the clinical incidence and causes of infection associated with their use. J Bone Joint Surg Am 72:1137–1143PubMed
16.
Sys G, Uyttendaele D, Poffyn B, Verdonk R, Verstraete KL (2002) Extracorporeally irradiated autografts in pelvic reconstruction after malignant tumour resection. Int Orthop 26:174–178PubMedCrossRef
17.
Uyttendaele D, De SA, Claessens H, Roels H, Berkvens P, Mondelaers W (1988) Limb conservation in primary bone tumours by resection, extracorporeal irradiation and re-implantation. J Bone Joint Surg Br 70:348–353PubMed
18.
Unni KK (1996) Dahlin’s bone tumors: General aspects and data on 11,087 cases, 5th edn. Lippincott Williams & Wilkins, Philadelphia
19.
Mondelaers W, VanLaere K, Goedefroot A, VandenBossche K (1996) The Ghent University 15 MeV high-current linear electron accelerator facility. Nucl Instr Methods Phys Res A 368:278–282CrossRef
20.
Mondelaers W, VanLaere K, Uyttendaele D (1993) Treatment of primary tumors of bone and cartilage by extracorporeal irradiation with a low-energy high-power electron linac. Nucl Instr Methods Phys Res B 79:898–900CrossRef
21.
Poffyn BA, Sys G, Van Maele G, Van Hoorebeke L, Forsyth R, Verstraete K, Uyttendaele D (2010) Radiographic analysis of extracorporeally irradiated autografts. Skelet Radiol. doi:10.​1007/​s00256-010-0889-1
22.
Sabo D, Brocai DR, Eble M, Wannenmacher M, Ewerbeck V (2000) Influence of extracorporeal irradiation on the reintegration of autologous grafts of bone and joint. Study in a canine model. J Bone Joint Surg Br 82:276–782PubMedCrossRef
23.
Voggenreiter G, Ascherl R, Blumel G, Schmit-Neuerburg KP (1996) Extracorporeal irradiation and incorporation of bone grafts: autogeneic cortical grafts studied in rats. Acta Orthop Scand 67:583–588PubMedCrossRef
24.
Takahashi S, Sugimoto M, Kotoura Y, Nishimatsu H, Shibamoto Y, Abe M, Yamamuro T (1994) The effects of intraoperative radiotherapy on bone-healing ability in relation to different doses and postradiotherapy intervals. Int J Radiat Oncol Biol Phys 30:1147–1152PubMed
25.
Anacak Y, Sabah D, Demirci S, Kamer S (2007) Intraoperative extracorporeal irradiation and re-implantation of involved bone for the treatment of musculoskeletal tumors. J Exp Cancer Res 26:571–574
Metadata
Title
Extracorporeally irradiated autografts for the treatment of bone tumours: tips and tricks
Authors
Bart Poffyn
Gwen Sys
Alexander Mulliez
Georges Van Maele
Luc Van Hoorebeke
Ramses Forsyth
Dirk Uyttendaele
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 6/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1098-1

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