Improvement of allograft-prosthetic composite reconstruction

Vyrva O.Ye., Golovina O.A., Golovina Y.A., Malyk R.V.

Summary. The objective of the study is bioreconstruction of a long bone affected by a tumor, reduction of complications in the case of allograft-prosthetic composite. Material and methods. Three methods of segmental bone allograft after bone tumor resection were improved, approbation of the developed methods was carried out. The first method is the replacement of the post-resection defect of distal tibia with an articulating alloimplant, the second method is allograft-prosthetic composite in proximal femur after tumor removal, the third method is to replace the post-resection defect of the diaphysal part of the long bone with a segmental allograft. Results. These techniques were used in 7 patients (5 men and 2 women) with malignant tumors of long bones. As a result of observation of patients the following complications were noted: ischemic necrosis of soft tissues — 1 case; tumor recurrence, which led to limb amputation — 1 patient. In all cases, there was fusion of the alloimplant and the recipient’s bone during the observation period from 6 to 12 months. The mean follow-up of patients ranged from 1 month to 1 year. The total number of complications was 2 cases (28.5%) (according to E.R. Henderson). Among them mechanical (fractures of structures, alloimplants) — 0, infectious — 0, tumor recurrence — 1 case (14%), ischemic necrosis of soft tissues in the surgery area — 1 patient (14%). Functional results averaged according to the scale MSTS — (71 ± 14)% (min — 45%, max — 76%), scale TESS — (73 ± 16)% (min — 48%, max — 80%). Conclusions. Bioreconstruction of segmental postresection defects of long bones promotes bone regeneration and surrounding soft tissues. Development and improvement of methods of surgical treatment of patients with malignant bone tumors allows to apply in practice the most effective treatments and improve the quality of life of this category of patients.

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