The effect of intramedullary cement on intercalary allograft reconstruction of bone defects after XXXX resection: a pilot study.

@entity5 @entity1 @entity1893 @entity262
OBJECTIVE: A pilot study to evaluate the surgical and functional results of resection and reconstruction of diaphyseal @entity5 with cemented and uncemented intercalary allografts. DESIGN: A retrospective case series. SETTING: A quaternary care unit within a teaching hospital. @entity1 : Twenty-two @entity1 with diaphyseal @entity5 treated between 1988 and 1992, with mean follow-up of 38 months (range from 20 to 70 months). INTERVENTIONS: Diagnostic biopsy in all @entity1 . Preoperative and postoperative chemotherapy in @entity1 with @entity1893 . En-bloc excision of all @entity5 . Reconstruction of the defect with cemented (15 @entity1 ) or uncemented (7 @entity1 ) intercalary allografts. MAIN OUTCOME MEASURES: Nonunion at one or both osteosynthesis sites, death from @entity262 , amputation. RESULTS: Six of the 22 @entity1 died of @entity262 with the graft intact, and 3 subsequently had amputation for either local recurrence (2 @entity1 ) or failure of free tissue transfer (1 @entity1 ), leaving 13 @entity1 alive with the allograft in situ at an average of 36 months (range from 24 to 64 months). There were no revision procedures to remove or replace the original allograft. Five @entity1 had nonunion at one or more osteosynthesis sites on plain radiographs 9 months after resection. Four @entity1 with nonunion were in the cemented group of 13 @entity1 available for assessment at 9 months, and 1 was in the uncemented group of 5 @entity1 available for assessment at 9 months. There were two graft fractures, both in the uncemented group. CONCLUSION: The results of this pilot study offer guarded support for the use of pressurized cement in allografts prior to reconstruction of intercalary defects.
