악성 골-연부 종양에서 저온 처리 자가골을 이용한 사지구제술

Abstract

Purpose: Through retrospective analysis of malignant tumor patients limb-salvaged by low-heat treated autobone, effectiveness of the pasteurized autobone was evaluated.

Materials and Methods: Twenty-seven patients who underwent limb salvage operation using low-heat treated autobone between 1994 and 2001, and followed up for minimum of 12 months were included in this study. The mean age at surgery was 21.9 years (range, 10-59), and the mean follow-up was 46.5 months (range, 19-79). Radiological evaluation of the proximal and distal potential union sites was carried out.

Results: In all cases, low-heat treated autobone grafting along with fixation by appropriate methods were performed. The overall union rate of the low-heat treated autobone with normal host bone was 77.4%, and the mean union time was 5.0 months(range, 3-8 months) after surgery. Single osteotomy site comprised 17 cases while double osteotomy sites comprised 7 cases. Among the single osteotomy cases, union rate of ten femur cases was 100%, and mean union time was 4.8 months. All seven distal humerus cases showed 100% union rate at mean union time of 5.6 months. Double osteotomy cases were all of the femur and 2 proximal(29%) and 5 distal(71%) sites showed union at an average of 6 months and 5.0 months. Complications included nonunion in five patients(18.5%), fracture in three patients(11.1%), shortening in one patient, resorption in one patient, and valgus deformity in one patient. The overall mean survival was 68 months, and 5-year survival rate was 66% based on a Kaplan-Meier survival analysis.

Conclusion: Limb salvage with Low-heat treated autobone graft might be an effective treatment option for primary bone sarcoma and could replace limb salvage with allograft bone.