Hemicortical Resection and Inlay Allograft Reconstruction for Primary Bone Tumors by M.P.A. Bus, J.A.M. Bramer, G.R. Schaap, H.W.B. Schreuder, P.C. Jutte,

Hemicortical Resection and Inlay Allograft Reconstruction for Primary Bone Tumors

by M.P.A. Bus, J.A.M. Bramer, G.R. Schaap, H.W.B. Schreuder, P.C. Jutte, I.C.M. van der Geest, M.A.J. van de Sande, and P.D.S. Dijkstra

J Bone Joint Surg AmVolume 97(9):738-750

May 6, 2015

©2015 by The Journal of Bone and Joint Surgery, Inc.

Radiograph made six weeks after resection of the anterior portion of the tibia and reconstruction with a 9-cm-long inlay allograft fixed to the host bone with two screws.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Two weeks later, the remaining cortex fractured at the level of the distal osteotomy site and was treated conservatively with a cast.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Radiograph of the affected leg made thirty months after the index surgery.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Preoperative radiograph showing a lesion, with alternating osteolytic and sclerotic areas, in close relationship with the dorsal cortex of the distal part of the femur.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Three months after resection of the tumor and fixation of an allograft to the host bone with a single screw, there are no clear signs of allograft incorporation.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Four years after the index procedure, there is sound incorporation of the allograft.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Failed reconstructions, with the reasons for failure and the final outcomes.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Kaplan-Meier curve for survival of the reconstruction, with failure for mechanical reasons (nonunion or fracture) as the end point (blue line), failure due to infection as the end point (red

line), and failure due to locally recurrent or residual tumor as t...

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.

Recommendations for treatment of primary bone tumors and fixation of hemicortical allografts.

M.P.A. Bus et al. J Bone Joint Surg Am 2015;97:738-750

©2015 by The Journal of Bone and Joint Surgery, Inc.