Modified Technique Using Allograft-prosthetic Composite in the Distal Femur After Bone Tumor Resection

Background: The purpose of this retrospective study was to analyze the results of treatment of bone tumor resection of the distal femur with the modified technique of allograft-prosthetic composite.

Methods: Twelve patients with distal femoral bone tumors were treated with deep-frozen cortical allograft struts and allograft-prosthesis composites. There were five males and seven females with a median age of 29.5y. The minimum follow-up time was 12mo (median, 45.7mo; range, 12-81mo). Diagnoses included osteosarcoma in five patients, chondrosarcoma in three patients, giant cell tumors in three patients, and malignant fibrous histiocytoma in one patient. Five osteosarcoma patients were treated with adjuvant chemotherapy.

Results: At the latest follow-up examination, 11 patients were alive with no evidence of disease, and the limb was preserved in nine patients. One patient died of pulmonary metastases with no evidence of local recurrence. Seven healed without complications. A surgical procedure was performed in four patients because of complications, which included a fracture (one patient), deep infection (one patient), instability (one patient), and local recurrence (one patient).

Conclusion: The modified technique of allograft-prosthetic composite is an effective treatment for bone tumor resection of the distal femur. This technique has many advantages, including augmentation of the bone stock, minimizing the risk of allograft fracture and nonunion, and decreasing the need for revision operations.