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Predictors of complications in heat‐treated autograft reconstruction after intercalary resection for malignant musculoskeletal tumors of the extremity
Author(s) -
Ikuta Kunihiro,
Nishida Yoshihiro,
Sugiura Hideshi,
Tsukushi Satoshi,
Yamada Kenji,
Urakawa Hiroshi,
Arai Eisuke,
Hamada Shunsuke,
Ishiguro Naoki
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25028
Subject(s) - medicine , nonunion , surgery , univariate analysis , diaphysis , fibula , resection , multivariate analysis , tibia , orthopedic surgery
Background Biological reconstruction with recycled heat‐treated autografts has been an option for a segmental skeletal defect after intercalary resection for malignant musculoskeletal tumors in the extremity. This study was undertaken to evaluate the clinical outcomes in patients treated with this procedure and identify factors affecting the incidence of complications. Methods We retrospectively reviewed 24 patients treated with heat‐treated autografts after intercalary resection at our institution between 1992 and 2015. Results The survival rate of the heat‐treated autografts was 70.1% at 10 years. Of the 48 host‐graft junctions in the 24 patients, nonunion occurred in 18 junctions (38%). In the univariate analysis, location in the upper extremity, intercalary grafts without vascularized fibula autografts (VFG), and junction at the diaphysis significantly increased the rate of nonunion ( P = 0.003, P = 0.003, and P = 0.031, respectively). Location in the upper extremity was an independent factor associated with nonunion in the multivariate analysis ( P = 0.006). Upper extremity location and intercalary grafts without VFG were also significant factors for bone absorption ( P = 0.042 and P < 0.001, respectively). Conclusions Our results can provide useful information to devise possibly novel clinical approaches to patients requiring intercalary reconstruction of the extremity.