Analysis of results in patients after treatment using various segmental bone alloplasty techniques

Abstract

Restoration of bone, adjacent joint and surrounding soft tissue integrity is an important factor in achieving full function of affected limbs in patients with bone tumors. Biological bone reconstruction has a number of advantages over other artificial implants. The aim of the work is to analyze the results of clinical approbation of the segmental alloimplant using by different methods for treatment of malignant bone tumors. Material and methods. The data of 17 patients with malignant tumors, secondary lesions or neoplasms of long bones with an aggressive course of the pathological process were analyzed. All patients underwent surgery to remove en-block tumors and replace post-resection defects of long bones with segmental bone alloimplants. Different methods of fixing bone alloimplants and sterilization of alloimplants were used. Three methods of surgery are presented. Results. The analysis of surgical treatment results in patients with long bone tumors who underwent bioreconstructive surgery was performed. The functional results according to the MSTS scale and complications of bioreconstructive operations according to the classification of Henderson E. et al. were assessed. The total number of complications was 58.8 %, among which local complications of the wound process were observed in 5.9 % of cases (1 patient), atrophic nonunion of the recipient bone and alloimplant – in 4 cases (23.5 %), violation of the metal fixator integrity – in 2 patients 11.8 %), infectious complications – in 5.9 % (1 patient), local recurrence of the tumor was the most common and amounted to 35.3 % (6 patients) of all cases. Conclusions. Bioreconstructive surgical interventions (using bone alloimplants) should be used according to clear indications to achieve the best results. The application of the developed methods presented in the work will reduce the risk of complications associated with bone alloplasty. Biological recovery of lost bone tissue and the fastest recovery of the affected limb through the use of metal structures allows a widespread use of this technique in cancer patients.