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Osteoarticular allograft reconstruction after distal radius tumor resection: Reoperation and patient reported outcomes
Author(s) -
Lans Jonathan,
Ballatori Sarah E.,
Castelein René M.,
Chen Neal C.,
Lozano Calderon Santiago A.
Publication year - 2021
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.26405
Subject(s) - medicine , wrist , surgery , arthrodesis , internal fixation , fixation (population genetics) , population , alternative medicine , environmental health , pathology
Background The aims of this study are to evaluate the rate of wrist joint preservation, allograft retention, factors associated with reoperation and to report the patient reported outcomes after osteoarticular allograft reconstruction of the distal radius. Methods Retrospective chart review identified 33 patients who underwent distal radius resection followed by osteoarticular allograft reconstruction, including 27 giant cell tumors and 6 primary malignancies. Ten patients with a preserved wrist joint completed the QuickDASH, PROMIS‐CA physical function, and Toronto extremity salvage score (TESS) at a median of 13 years postoperatively. Results The allograft retention rate was 89%, and an allograft fracture predisposed to conversion to wrist arthrodesis. The reoperation rate was 55% and 36% underwent wrist arthrodesis at a median of 4.2 years following index surgery. The use of locking plate fixation was associated with lower reoperation and allograft fracture rates. Patients reported a median QuickDASH of 10.2 (range: 0–52.3), a mean PROMIS physical function of 57.8 (range: 38.9–64.5) and the median TESS was 95.5 (range: 67.0–98.4). Conclusion Osteoarticular allograft reconstruction results in acceptable long‐term patient reported outcomes, despite a high revision rate. Allograft fixation with locking plates seems to reduce the number of reoperations and allograft fractures, along with reduction in wrist arthrodesis rates.