Resit SEVİMLİ

Comparison of medium-period outcomes of allografts and autografts used in repair of bone defects in patients who were treated in our department due to skeletal system tumors

Objective: In orthopaedic oncology, reconstruction with autograft or allograft of bone defects which develop following tumor resection or curettage is a commonly used method. Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so. Successful results of allografts or autograft in reconstruction of bone defect after tumor resection encouraged its utilization in post-traumatic defects. In this study, prospective representation of clinical and radiological medium-period outcomes of used autgrafts and allografts is aimed.Materials and Methods: 45 patients who were treated, for whom reconstruction was performed by using allograft or autograft following tumor excision or curettage between the years 2005-2015 in Inonu University Faculty of Medicine were included in the study. Patients were evaluated in regard to age, gender, tumor localization and union. Obtained data were analyzed by SPSS software version 15.0Results: During follow-ups of the patients; union was radiologically observed in an average of 6.1 months in 43 (91%) patients (in 21 autografts it was 5.8 months, in 22 allografts it was 6.5 months). Nonunion occurred in 2 (9%) patients. No statistically significant difference was determined between groups with allografts and autografts (P>0.05).Conclusion: No difference was determined between use of either autogenous or allogenous grafts in segmental or cavitary bone defects, and reconstruction is a method with high success.

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Tomford WW, Starkweather RJ, Goldman MH. A study of the clinical incidence of infection in the use of banked allograft bone. J Bone Joint Surg Am 1981;63(2):244-8.
Swenson CL, Arnoczky SP. Demineralization for inactivation of infectious retrovirus in systemically infected cortical bone: in vitro and in vivo experimental studies. J Bone Joint Surg Am 2003;85-A(2):323-32.
Connolly JF, Guse R, Tiedeman J, Dehne R. Autologous marrow injection as a substitute for operative grafting of tibial nonunions. Clin Orthop Relat Res 1991;(266):259-70.
Lee EH, Goh JC, Helm R, Pho RW. Donor site morbidity following resection of the fibula. J Bone Joint Surg Br 1990;72(1):129-31.
Springfield D. Autograft reconstructions. Orthop Clin North Am 1996;27(3):483-92.
Kumar VP, Satku K, Helm R, Pho RW. Radial reconstruction in segmental defects of both forearm bones. J Bone Joint Surg Br 1988;70(5):815-7.
Yadav SS. Dual-fibular grafting for massive bone gaps in the lower extremity. J Bone Joint Surg Am 1990;72(4):486-94.
Doi K, Tominaga S, Shibata T. Bone grafts with microvascular anastomoses of vascular pedicles: an experimental study in dogs. J Bone Joint Surg Am 1977;59(6):809-15.
Devas MB, Sweetnam R. Stress fractures of the fibula; a review of fifty cases in athletes. J Bone Joint Surg Br 1956;38-B(4):818-29.
Smith RJ, Mankin HJ. Allograft replacement of distal Radius for giant cell tumor. J Hand Surg Am 1977;2(4):299-308.
Veth R, van Hoesel R, Pruszczynski M, Hoogenhout J, Schreuder B, Wobbes T. Limb salvage in musculoskeletal oncology. Lancet Oncol 2003;4(6):343-50.
Loty B, Courpied JP, Tomeno B, Postel M, Forest M, Abelanet R. Bone allografts sterilised by irradiation. Biological properties, procurement and results of 150 massive allografts. Int Orthop 1990;14:237-42.
Vaccaro AR. The role of the osteoconductive scaffold in synthetic bone graft. Orthopedics 2002;25(5 Suppl):s571-8.
Vaccaro AR, Chiba K, Heller JG, Patel TCh, Thalgott JS, Truumees E. et al. NorthAmerican Spine Society for Contemporary Concepts in Spine Care. Bone grafting alternatives in spinal surgery. Spine J 2002;2(3):206-15.
Viggeswarapu M, Boden SD, Liu Y, Hair GA, Louis-Ugbo J, Murakami H. et al: Adenoviral delivery of LIM mineralization protein-1 induces new bone formation in vitro and in vivo. J Bone Joint Surg Am 2001;83-A(3):364-76.
Betz RR. Limitations of autograft and allograft: new synthetic solutions. Orthopedics 2002;25(5 Suppl):s561-70.
Parikh SN. Bone graft substitutes: past, present, future. J Postgrad Med 2002;48(2):142-8.
Nash TJ, Howlett CR, Martin C, Steele J, Johnson KA, Hicklin DJ. Effect of platelet-derived growth factor on tibial osteotomies in rabbits. Bone 1994;15(2):203-8.