Objectives
For skeletal reconstruction in surgery for bone tumors, pasteurization of the bone has been used with favorable results over other methods of recycling.
Patients and methods
Ten patients with osteosarcoma of the proximal humerus were treated by wide margin resection and reconstruction with pasteurized osteo-articular autologous bone graft. They were seven females and three males, between 9 and 30 years of age who were followed up for at least 3 years (mean, 48 months). The International Society of Limb Salvage graft evaluation method was used for the evaluation of the radiographs.
Results
Six (60%) patients had complete incorporation of the graft and three (30%) patients had partial incorporation. The mean radiographic scoring rate was 84%. Viability of the grafts was evaluated by bone scintigraphy. Of the nine patients evaluated, uptake was detected in seven patients from ∼6 months postoperatively after which it increased gradually. The functional results were assessed by the system of the Musculoskeletal Tumor Society and the mean functional rating was 90%. Seven patients have been disease free and three have died of the disease. Resorption of the graft was seen in a single, 9-year-old patient (10%); no fractures or infections were seen. No local recurrence was detected.
Conclusion
These results indicate that pasteurization of the bone may be a useful option for reconstruction after resection of osteosarcoma of the proximal humerus. The advantages of extracorporeal pasteurization include convenience of use, avoidance of intraspecies infection and allogenic reactions, and satisfactory bone remodeling.