|Study: Pasteurized Autografts May Not be Durable for Long-term Survival Following Bone Tumor Resections
According to a study published in the September issue of Clinical Orthopaedics and Related Research, pasteurized autografts may not be the best long-term reconstructive option for managing bone defects after tumor resection. Of 1,358 tumor reconstructions performed between 1988 and 2013, 353 used pasteurized autograft. Patients were grouped by type of pasteurized bone use: pasteurized autograft-prosthesis composites (PPCs) (n = 149), intercalary grafts (n = 71), hemicortical grafts (n = 15), osteoarticular (n = 12), and fusion of a joint (n = 31). Other methods included endoprostheses (n = 508), instant arthrodesis using an intramedullary nail and bone cement (n = 286), allografts (n = 97), and resection only (n = 114). At five, 10, and 20 years of follow-up, the survival of 278 autografts was 73 percent, 59 percent, and 40 percent, respectively. Of those, 105 (38 percent) were removed with complications, including infection (13 percent, n = 33), nonunion (7 percent, n = 18), graft fracture (6 percent, n = 16), graft resorption (5 percent, n = 14), and local recurrence (4 percent, n = 11). Patient age ≤ 15 years, male sex, and pelvic location were all associated with graft removal. After 20 years, survival rates for osteoarticular and hemicortical reconstructions were 92 percent and 80 percent, respectively. Intercalary, PPC, and fusion survival rates were 46 percent, 37 percent, and 28 percent, respectively.
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