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Published in: World Journal of Surgical Oncology 1/2012

Open Access 01-12-2012 | Research

Limb salvage in osteosarcoma using autoclaved tumor-bearing bone

Authors: Kok Long Pan, Wai Hoong Chan, Gek Bee Ong, Shanmugam Premsenthil, Mohammad Zulkarnaen, Dayangku Norlida, Zainal Abidin

Published in: World Journal of Surgical Oncology | Issue 1/2012

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Abstract

Background

Tumor prostheses currently give the best short- and medium-term results for limb-salvage reconstruction procedures in the treatment of bone tumors. However, in developing countries, the cost of a tumor prosthesis is beyond the reach of much of the population. We report the use of autoclaved tumor-bearing bone in 10 patients, as an affordable alternative to the use of prostheses.

Methods

This is a case series of 10 patients (mean age 19 years) with osteosarcoma who were treated at our hospital from 1998 to 2008, and followed up for a mean of 35 months (range 14 to 8). The femur was involved in six cases, the humerus in three cases, and the ulna in one case. The mean length of the autoclaved bone was 150 mm (range 60–210).

Results

Bone union occurred in seven patients over an mean duration of 12 months (range 8–17). Three patients had non-union. Two of these had associated implant failure, with one of them also developing chronic infection, and the third is still being followed up. Two other patients had local recurrence.

Conclusion

The use of autoclaved tumor grafts provides an inexpensive limb-salvage option without sacrificing appropriate oncologic principles. A painless and stable limb is achievable, and the use of this technique can be further refined.
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Literature
1.
go back to reference Akiode O, Shonubi AM, Musa A, Sule G: Major limb amputations: an audit of indications in a suburban surgical practice. J Natl Med Assoc. 2005, 97 (1): 74-8.PubMedCentralPubMed Akiode O, Shonubi AM, Musa A, Sule G: Major limb amputations: an audit of indications in a suburban surgical practice. J Natl Med Assoc. 2005, 97 (1): 74-8.PubMedCentralPubMed
2.
go back to reference Marulanda GA, Henderson ER, Johnson DA: Orthopedic surgery options for the treatment of primary osteosarcoma. Cancer Control. 2008, 15 (1): 13-20.PubMed Marulanda GA, Henderson ER, Johnson DA: Orthopedic surgery options for the treatment of primary osteosarcoma. Cancer Control. 2008, 15 (1): 13-20.PubMed
3.
go back to reference Poon KB, Chien SH, Lin GT, Wang GJ: Impact of national health insurance on the survival rate of patients with osteosarcoma in Taiwan: review of 74 patients. Kaohsiung J Med Sci. 2004, 20 (5): 230-4. 10.1016/S1607-551X(09)70111-1.CrossRefPubMed Poon KB, Chien SH, Lin GT, Wang GJ: Impact of national health insurance on the survival rate of patients with osteosarcoma in Taiwan: review of 74 patients. Kaohsiung J Med Sci. 2004, 20 (5): 230-4. 10.1016/S1607-551X(09)70111-1.CrossRefPubMed
4.
go back to reference Harris IE, Leff AR, Gitelis S, Simon MA: Function after amputation, arthrodesis or arthroplasty for tumors about the knee. J Bone Joint Surg (Am). 1990, 72 (10): 1477-85. Harris IE, Leff AR, Gitelis S, Simon MA: Function after amputation, arthrodesis or arthroplasty for tumors about the knee. J Bone Joint Surg (Am). 1990, 72 (10): 1477-85.
5.
go back to reference Hurson BJ: Limb-sparing surgery for patients with sarcomas. J Bone Joint Surg (Br). 1995, 77: 173-174. Hurson BJ: Limb-sparing surgery for patients with sarcomas. J Bone Joint Surg (Br). 1995, 77: 173-174.
6.
go back to reference Donati D, Giacomini S, Gozzi E, Salphale Y, Mercuri M, Mankin HJ: Allograft arthrodesis treatment of bone tumors: A two-center study. Clin Orthop Relat Res. 2002, 400: 217-224.CrossRefPubMed Donati D, Giacomini S, Gozzi E, Salphale Y, Mercuri M, Mankin HJ: Allograft arthrodesis treatment of bone tumors: A two-center study. Clin Orthop Relat Res. 2002, 400: 217-224.CrossRefPubMed
7.
go back to reference Mercuri M, Capanna R, Manfrini M, Bacci G, Picci P, Ruggieri P: The management of malignant bone tumors in children and adolescence. Clin Orthop Relat Res. 1991, 264: 156-68.PubMed Mercuri M, Capanna R, Manfrini M, Bacci G, Picci P, Ruggieri P: The management of malignant bone tumors in children and adolescence. Clin Orthop Relat Res. 1991, 264: 156-68.PubMed
8.
go back to reference Wittig JC, Bickels J, Kellar-Graney KL, Kim FH, Malawer MM: Osteosarcoma of the proximal humerus: Long-term results with limb-sparing surgery. Clin Orthop Relat Res. 2002, 397: 156-176.CrossRefPubMed Wittig JC, Bickels J, Kellar-Graney KL, Kim FH, Malawer MM: Osteosarcoma of the proximal humerus: Long-term results with limb-sparing surgery. Clin Orthop Relat Res. 2002, 397: 156-176.CrossRefPubMed
9.
go back to reference Bodde EWH, de Visser E, Duysens JEJ, Hartman EHM: Donor-site morbidity after free vascularised autogenous fibular transfer: Subjective and quantitative analyses. Plastic Reconstructive Surgery. 2003, 111 (7): 2237-2242. 10.1097/01.PRS.0000060086.99242.F1.CrossRefPubMed Bodde EWH, de Visser E, Duysens JEJ, Hartman EHM: Donor-site morbidity after free vascularised autogenous fibular transfer: Subjective and quantitative analyses. Plastic Reconstructive Surgery. 2003, 111 (7): 2237-2242. 10.1097/01.PRS.0000060086.99242.F1.CrossRefPubMed
10.
go back to reference Manabe J, Ahmad AR, Kawaguchi N, Matsumoto S, Kuroda H: Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma. Clin Ortho Relat Res. 2004, 419: 258-66.CrossRef Manabe J, Ahmad AR, Kawaguchi N, Matsumoto S, Kuroda H: Pasteurized autologous bone graft in surgery for bone and soft tissue sarcoma. Clin Ortho Relat Res. 2004, 419: 258-66.CrossRef
11.
go back to reference Khattak MJ, Umer M, Ur-Rasheed H, Umar M: Autoclaved tumor bone for reconstruction: An alternative in developing countries. Clin Orthop Relat Res. 2006, 447: 138-44.CrossRefPubMed Khattak MJ, Umer M, Ur-Rasheed H, Umar M: Autoclaved tumor bone for reconstruction: An alternative in developing countries. Clin Orthop Relat Res. 2006, 447: 138-44.CrossRefPubMed
12.
go back to reference Suk KS, Shin KH, Hahn SB: Limb salvage using original low heat-treated tumor-bearing bone. Clin Orthop Relat Res. 2006, 397: 385-393.CrossRef Suk KS, Shin KH, Hahn SB: Limb salvage using original low heat-treated tumor-bearing bone. Clin Orthop Relat Res. 2006, 397: 385-393.CrossRef
13.
go back to reference Chang HC, Pho RWH, Kumar VP: Extremity osteosarcoma – a Southeast Asian experience. Annals Acad Med S’pore. 2002, 31 (5): 598-606. Chang HC, Pho RWH, Kumar VP: Extremity osteosarcoma – a Southeast Asian experience. Annals Acad Med S’pore. 2002, 31 (5): 598-606.
14.
go back to reference Pan KL, Zolqarnain A, Chia YY: Delay in treatment of primary malignant and aggressive musculoskeletal tumours. Med J Mal. 2006, 61 (Supple A): 53-56. Pan KL, Zolqarnain A, Chia YY: Delay in treatment of primary malignant and aggressive musculoskeletal tumours. Med J Mal. 2006, 61 (Supple A): 53-56.
Metadata
Title
Limb salvage in osteosarcoma using autoclaved tumor-bearing bone
Authors
Kok Long Pan
Wai Hoong Chan
Gek Bee Ong
Shanmugam Premsenthil
Mohammad Zulkarnaen
Dayangku Norlida
Zainal Abidin
Publication date
01-12-2012
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2012
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-10-105

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