Prospective Study of Limb Salvage Surgery using Allograft in Malignant and Aggressive Benign Bone Tumours

Mageswaran, S (2006) Prospective Study of Limb Salvage Surgery using Allograft in Malignant and Aggressive Benign Bone Tumours. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: “Bone is the most commonly transplanted tissue in the body than any other tissue or organ except blood”. Transplanted bone, tendon and ligaments are used extensively in orthopedics, neurosurgery, dental surgery and plastic surgery for procedures including repair of fractures and damage caused by illness and injury. Allografts are preferred over synthetic implants by value of their desirable features of natural structure, shape and strength and biological capacity of incorporation. Bone is a unique tissue in that its ability to regenerate is more predictable than any other tissue in the body. Bone is often destroyed by infection, tumor, trauma and implanted materials and has to be replaced to restore structure and function. AIM: To evaluate the functional outcome of limb salvage surgery using allografts in malignant and borderline malignant bone tumors. MATERIALS AND METHODS: The materials for this study was based on a prospective study conducted at the Department of Orthopaedics and Traumatology, Government General Hospital, Chennai from a period of July 2003 to August 2005. Our inclusion Criteria for allografting are 1. Malignant bone tumors - Enneking staging I A to II B, 2. Aggressive benign tumors. Exclusion criteria are; 1. Presence of metastasis, 2. Involvement of major neurovascular structure, 3. Biopsy scars in atypical sites, 4. Presence of infection. In our 16 cases, 8 cases were malignant bone tumors and 8 cases were aggressive benign bone tumors. In malignant tumors, 3 tumors were belonging to Enneking grade II A and 5 tumors belonging to Enneking grade II B. All benign tumors were aggressive tumors according to Enneking grade. RESULTS: The results were evaluated by using Enneking scoring system. This system of functional evaluation has been adapted by the Musculoskeletal Tumor Society (MSTS) and International Symposium of Limb Salvage (ISOLS). This system assigns numerical values (0-5) for each of six categories. Pain, function and emotional acceptance in upper and lower extremities supports, and walking and gait in the lower extremity, and hand positioning, and dexterity and lifting ability in the upper extremity. In overall, the functional results as well as complication rates in our series are comparable with standard series. CONCLUSION: Massive bone allografts are one of the options for reconstruction after resection of bone tumors. Adequate tumors resection is the most important factor in determining local recurrence there by limb and patient survival. Autogenous cancellous bone grafting to be done in all cases at allograft host junction to improve union. Complication rates are higher in limb salvage therapy using allograft than amputation, and the patients should be properly motivated for long postoperative rehabilitation therapy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Limb Salvage Surgery ; Allograft ; Malignant ; Aggressive Benign Bone Tumours ; Prospective Study
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 01:45
Last Modified: 14 Sep 2017 01:45

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