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J Knee Surg 2019; 32(04): 315-321
DOI: 10.1055/s-0038-1672123
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Allograft Reconstruction of the Knee—Methods and Outcomes

H. Thomas Temple
1   Office of Translational Research and Economic Development, Nova Southeastern University, Fort Lauderdale, Florida
2   Department of Surgery, Mercy Hospital, Miami, Florida
› Author Affiliations
Further Information

Publication History

17 July 2018

15 August 2018

Publication Date:
27 September 2018 (online)

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Abstract

Although allograft usage has decreased over the past three decades in favor of segmental metal implants, they still have an important role in the reconstruction of large osteochondral defects following tumor resection. The decline of allografts in limb salvage is multifactorial and includes limited availability, technical difficulty, increased rates of infection and fracture, and unpredictable results. There are circumstances where allograft transplantation is useful around the knee resulting in improved function, bone and joint preservation, and acceptable long-term outcomes.

Keywords

allograft reconstruction - knee - allograft
 

  • References

  • 1 MacEwen W. Observations concerning transplantation of bone: illustrated by a case of inter-human osseous transplantation, whereby over two-thirds of the shaft of a humerus was restored. Proc R Soc Lond 1881; 32: 232-247
    CrossrefPubMedGoogle Scholar
  • 2 Lexer E. The Classic: The Use of Free Osteoplasty Together with Trials on Arthrodesis and Joint Transplantation [Die Verwendung der freien Knochenplastik nebst Versuchen uber Gelenkversteifung und Gelenktransplantation]. Clin Orthop Relat Res 2008; 466 (08) 1771-1776
    CrossrefPubMedGoogle Scholar
  • 3 Lexer E. Joint transplantation and arthroplasty. Surg Cynec Obstet 1925; 40: 782-788
    PubMedGoogle Scholar
  • 4 Carrel A. The preservation of tissues and its application in surgery. JAMA 1912; 59: 523-527
    PubMedGoogle Scholar
  • 5 Tomford WW. Bone allografts: past, present and future. Cell Tissue Bank 2000; 1 (02) 105-109
    CrossrefPubMedGoogle Scholar
  • 6 Hyatt GW. Fundamentals in the use and preservation of homogenous bone. U S Armed Forces Med J 1950; 1 (08) 841-852
    PubMedGoogle Scholar
  • 7 Hyatt GW, Turner TC, Bassett CAL, Pate JW, Sawyer PN. New methods for preserving bone, skin and blood vessels. Postgrad Med 1952; 12 (03) 239-254
    CrossrefPubMedGoogle Scholar
  • 8 Parrish FF. Allograft replacement of all or part of the end of a long bone following excision of a tumor. J Bone Joint Surg Am 1973; 55 (01) 1-22
    CrossrefPubMedGoogle Scholar
  • 9 Volkov M. Allotransplantation of joints. J Bone Joint Surg Br 1970; 52 (01) 49-53
    PubMedGoogle Scholar
  • 10 Ottolenghi CE. Massive osteoarticular bone grafts. Transplant of the whole femur. J Bone Joint Surg Br 1966; 48 (04) 646-659
    PubMedGoogle Scholar
  • 11 Mankin HJ, Fogelson FS, Thrasher AZ, Jaffer F. Massive resection and allograft transplantation in the treatment of malignant bone tumors. N Engl J Med 1976; 294 (23) 1247-1255
    CrossrefPubMedGoogle Scholar
  • 12 Mnaymneh W, Malinin T. Massive allografts in surgery of bone tumors. Orthop Clin North Am 1989; 20 (03) 455-467
    PubMedGoogle Scholar
  • 13 Mnaymneh W, Malinin TI, Makley JT, Dick HM. Massive osteoarticular allografts in the reconstruction of extremities following resection of tumors not requiring chemotherapy and radiation. Clin Orthop Relat Res 1985; (197) 76-87
    PubMedGoogle Scholar
  • 14 Centers for Disease Control (CDC). Transmission of HIV through bone transplantation: case report and public health recommendations. MMWR Morb Mortal Wkly Rep 1988; 37 (39) 597-599
    PubMedGoogle Scholar
  • 15 Eggen BM, Nordbø SA. Transmission of HCV by organ transplantation. N Engl J Med 1992; 326 (06) 411
    PubMedGoogle Scholar
  • 16 Conrad EU, Gretch DR, Obermeyer KR. , et al. Transmission of the hepatitis-C virus by tissue transplantation. J Bone Joint Surg Am 1995; 77 (02) 214-224
    CrossrefPubMedGoogle Scholar
  • 17 Buck BE, Malinin TI, Brown MD. Bone transplantation and human immunodeficiency virus. An estimate of risk of acquired immunodeficiency syndrome (AIDS). Clin Orthop Relat Res 1989; (240) 129-136
    PubMedGoogle Scholar
  • 18 Eastlund T. Infectious disease transmission through cell, tissue, and organ transplantation: reducing the risk through donor selection. Cell Transplant 1995; 4 (05) 455-477
    CrossrefPubMedGoogle Scholar
  • 19 Mallick TK, Mosquera A, Zinderman CE, , St. Martin L, Wise RP. Reported infections after human tissue transplantation before and after new food and drug administration (FDA) regulations, United States, 2001 through June, 2010. Cell Tissue Bank 2012; 13 (02) 259-267
    CrossrefPubMedGoogle Scholar
  • 20 Lord CF, Gebhardt MC, Tomford WW, Mankin HJ. Infection in bone allografts. Incidence, nature, and treatment. J Bone Joint Surg Am 1988; 70 (03) 369-376
    CrossrefPubMedGoogle Scholar
  • 21 Sorger JI, Hornicek FJ, Zavatta M. , et al. Allograft fractures revisited. Clin Orthop Relat Res 2001; 382 (382) 66-74
    CrossrefPubMedGoogle Scholar
  • 22 Berrey Jr BH, Lord CF, Gebhardt MC, Mankin HJ. Fractures of allografts. Frequency, treatment, and end-results. J Bone Joint Surg Am 1990; 72 (06) 825-833
    CrossrefPubMedGoogle Scholar
  • 23 Henderson ER, O'Connor MI, Ruggieri P. , et al. Classification of failure of limb salvage after reconstructive surgery for bone tumours: a modified system Including biological and expandable reconstructions. Bone Joint J 2014; 96-B (11) 1436-1440
    CrossrefPubMedGoogle Scholar
  • 24 Henderson ER, Groundland JS, Pala E. , et al. Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review. J Bone Joint Surg Am 2011; 93 (05) 418-429
    CrossrefPubMedGoogle Scholar
  • 25 AlGheshyan F, Eltoukhy M, Zakaria K, Temple HT, Asfour S. Comparison of gait parameters in distal femoral replacement using a metallic endoprosthesis versus allograft reconstruction. J Orthop 2015; 12 (Suppl. 01) S25-S30
    PubMedGoogle Scholar
  • 26 DeGroot III H, Mankin H. Total knee arthroplasty in patients who have massive osteoarticular allografts. Clin Orthop Relat Res 2000; (373) 62-72
    PubMedGoogle Scholar
  • 27 Hornicek FJ, Gebhardt MC, Tomford WW. , et al. Factors affecting nonunion of the allograft-host junction. Clin Orthop Relat Res 2001; (382) 87-98
    PubMedGoogle Scholar
  • 28 Albergo JI, Gaston CL, Aponte-Tinao LA. , et al. Proximal tibia reconstruction after bone tumor resection: are survivorship and outcomes of endoprosthetic replacement and osteoarticular allograft similar?. Clin Orthop Relat Res 2017; 475 (03) 676-682
    CrossrefPubMedGoogle Scholar
  • 29 Ramseier LE, Malinin TI, Temple HT, Mnaymneh WA, Exner GU. Allograft reconstruction for bone sarcoma of the tibia in the growing child. J Bone Joint Surg Br 2006; 88 (01) 95-99
    PubMedGoogle Scholar
  • 30 Mnaymneh W, Malinin TI, Lackman RD, Hornicek FJ, Ghandur-Mnaymneh L. Massive distal femoral osteoarticular allografts after resection of bone tumors. Clin Orthop Relat Res 1994; (303) 103-115
    PubMedGoogle Scholar
  • 31 Muscolo DL, Ayerza MA, Aponte-Tinao LA, Ranalletta M. Use of distal femoral osteoarticular allografts in limb salvage surgery. J Bone Joint Surg Am 2005; 87 (11) 2449-2455
    PubMedGoogle Scholar
  • 32 Toy PC, White JR, Scarborough MT, Enneking WF, Gibbs CP. Distal femoral osteoarticular allografts: long-term survival, but frequent complications. Clin Orthop Relat Res 2010; 468 (11) 2914-2923
    CrossrefPubMedGoogle Scholar
  • 33 Muscolo DL, Ayerza MA, Aponte-Tinao LA, Abalo E, Farfalli G. Unicondylar osteoarticular allografts of the knee. J Bone Joint Surg Am 2007; 89 (10) 2137-2142
    CrossrefPubMedGoogle Scholar
  • 34 Bus MP, Bramer JA, Schaap GR. , et al. Hemicortical resection and inlay allograft reconstruction for primary bone tumors: a retrospective evaluation in the Netherlands and review of the literature. J Bone Joint Surg Am 2015; 97 (09) 738-750
    CrossrefPubMedGoogle Scholar
  • 35 Simon MA, Bos GD. Epiphyseal extension of metaphyseal osteosarcoma in skeletally immature individuals. J Bone Joint Surg Am 1980; 62 (02) 195-204
    CrossrefPubMedGoogle Scholar
  • 36 Enneking WF, Kagan II A. Transepiphyseal extension of osteosarcoma: incidence, mechanism, and implications. Cancer 1978; 41 (04) 1526-1537
    CrossrefPubMedGoogle Scholar
  • 37 Norton KI, Hermann G, Abdelwahab IF, Klein MJ, Granowetter LF, Rabinowitz JG. Epiphyseal involvement in osteosarcoma. Radiology 1991; 180 (03) 813-816
    CrossrefPubMedGoogle Scholar
  • 38 Gao S, Zheng Y, Cai Q, Yao W, Wang J. Preliminary clinical research on epiphyseal distraction in osteosarcoma in children. World J Surg Oncol 2014; 12: 251
    CrossrefPubMedGoogle Scholar
  • 39 Xu SF, Yu XC, Xu M, Chen X. Successful management of a childhood osteosarcoma with epiphysiolysis and distraction osteogenesis. Curr Oncol 2014; 21: 658-662
    CrossrefPubMedGoogle Scholar
  • 40 Li J, Wang Z, Guo Z, Chen GJ, Yang M, Pei GX. Precise resection and biological reconstruction under navigation guidance for young patients with juxta-articular bone sarcoma in lower extremity: preliminary report. J Pediatr Orthop 2014; 34 (01) 101-108
    CrossrefPubMedGoogle Scholar
  • 41 Wong KC, Kumta SM. Joint-preserving tumor resection and reconstruction using image-guided computer navigation. Clin Orthop Relat Res 2013; 471 (03) 762-773
    CrossrefPubMedGoogle Scholar
  • 42 Kim JH, Kang HG, Kim HS. MRI-guided navigation surgery with temporary implantable bone markers in limb salvage for sarcoma. Clin Orthop Relat Res 2010; 468 (08) 2211-2217
    CrossrefPubMedGoogle Scholar
  • 43 Li J, Wang Z, Ji C, Chen G, Liu D, Zhu H. What are the oncologic and functional outcomes after joint salvage resections for juxtacortical osteosarcoma about the knee?. Clin Orthop Relat Res 2017; 475 (08) 2095-2104
    CrossrefPubMedGoogle Scholar