An osteoarticular allograft was used to reconstruct a skeletal
deficiency in sixteen patients after resection of a tumor in the proximal
end of the tibia. The status of each allograft and the condition of each
involved limb were evaluated an average of nine years (range, six to
fourteen years) postoperatively. The status of the allograft was evaluated
according to the survival of the allograft and the occurrence of
complications. Of the original sixteen allografts, seven were removed: six,
between two and five years after the reconstruction and one, seven years
after the reconstruction. A second reconstruction with use of an allograft
was performed in five of the seven patients. Fifteen complications occurred
in association with eleven of the original sixteen allografts. These
included fracture of the allograft (five patients), subchondral collapse
(five patients), infection (two patients), non-union (two patients), and
instability of the joint (one patient). At the latest follow-up
examination, nine patients had retained the original allograft, five had
had a second allograft procedure, and two had had an above-the-knee
amputation. The most recent result was rated excellent or good in eleven
patients and fair or a failure in five, with use of the system of Mankin et
al. It was rated good or excellent in nine patients and fair, poor, or a
failure in six, and it was not rated in one patient who had died, according
to the system of the Musculoskeletal Tumor Society.(ABSTRACT TRUNCATED AT
250 WORDS)