Therapeutic Effect of Uncemented Allograft-prosthetic Composite for the Reconstruction of Tumorous Bone Defect

Objective To investigate the surgical techniques and mid-term efficacy of reconstruction for proximal femur with allograft-prosthetic composite （APC）. Methods Fifteen patients who underwent uncemented APC reconstruction of proximal femur after bone tumor resection were retrospectively evaluated. Image and physical examinations were taken on the 1st, 3rd, 6th, 9th and 12th month after surgery and every 6 months thereafter to assess union condition, greater trochanteric bone absorption and myodynamia of abductors. Musculoskeletal Tumor Society (MSTS) and Harris Hip Score (HHS) were utilized to evaluate the function of hip joint. Results Seven male and eight female patients were included with average age of 25.1 years(17-56 years) and average followup of 32.8 months(18-48 months). Four patients had giant cell tumor of the bone, 3 patients had osteosarcoma, 3 patients had chondrosarcoma, 2 patients had malignant fibrous histiotoma, 2 patients had osteoblastoma and 1 patient had Ewing sarcoma. Unions occurred in the allograft-host bone interfaces of all patients in the period of 5-9 months postoperatively. Bone absorption in the allograft-host bone interfaces, dislocation, hypersensitivity of the allograft and acetabulum abrasion were not observed, while there were no metastasis and tumor recurrence. Three patients had periprosthetic fractures intraoperatively and were well fixed with cerclage. Absorptions in the greater trochanteric happened to 6 patients. All patients had mean MSTS and HHS scores of 11.3 (7-15) and 47.3 (40.3-58.5) preoperatively and 26.1(24-29) and 80.1(66.2-92.7) postoperatively. Conclusion Uncemented APC reconstruction is proper for young patients with long life expectancy and high demand of function that suffered from tumors of proximal femur.