Massive allografts in tumour surgery

We offer our personal experience of the use of massive bone allografts after tumour resection. We demonstrate the long-term results from 71 patients (72 allografts) operated on between 1961 and 1990. The long-term survival rate in osteoarticular and intercalary grafts is around 60%. Fractures of the graft can be salvaged in most cases. Infection leads to the removal of the graft in almost all cases. Factors influencing the survival, remodelling and complications of the grafts are discussed. The regime of cryopreservation, fixation and loading of the graft influence these factors, as do the use of autologous bone chips around the allograft-host junction and the application of chemotherapy or radiation. Fracture of the graft can be salvaged in most cases, as opposed to infection which remains the most severe complication and can occur at any time. Even with the improvement of tumour endoprostheses, the use of allografts remains an option, especially in young patients.