Massive allografts in tumour surgery

We offer our personal experience of the use of massive bone allografts after tumour resection. We demonstrate the long-term results from 71 patients (72 allografts) operated on between 1961 and 1990. The long-term survival rate in osteoarticular and intercalary grafts is around 60%. Fractures of the graft can be salvaged in most cases. Infection leads to the removal of the graft in almost all cases. Factors influencing the survival, remodelling and complications of the grafts are discussed. The regime of cryopreservation, fixation and loading of the graft influence these factors, as do the use of autologous bone chips around the allograft–host junction and the application of chemotherapy or radiation. Fracture of the graft can be salvaged in most cases, as opposed to infection which remains the most severe complication and can occur at any time. Even with the improvement of tumour endoprostheses, the use of allografts remains an option, especially in young patients

Resection of Periacetabular Lesions

Peri-acetabular pelvic resections are demanding operations with complex indications, anatomy, and postoperative rehabilitation. Sir Gordon Gordon-Taylor of Britain in 1935 called hindquarter amputations “one of the most colossal mutilations practiced on the human frame.” [1] It was attempted with and without success prior to the turn of the twentieth century with Girard of Berne documenting the first nonfatal pelvic resection for sarcoma in 1895 [2]. As the knowledge base of pelvic anatomy, oncology, and imaging technology grew, more attempts at hemipelvectomy were made, and various techniques were developed. The application of cross-sectional imaging as well as the rise of metallurgy and implant development in the 1970s expanded the indications of this operation