A systematic approach to the surgical treatment of patients with long bone tumors using bone segmental alloimplants

Authors

DOI:

https://doi.org/10.15674/0030-598720221-226-33

Keywords:

Malignant bone tumors, bone allograft, surgical treatment of malignant bone tumors

Abstract

The most common techniques for the replacement of post-resection bone defects in patients with tumors are modular and individual
endoprosthetics and bioreconstructive interventions. The following issues require solution: improvement and development of techniques
for fixation of segmental allograft and recipient bone, study of bone remodeling processes in conditions of bone allograft and
cytostatics (chemotherapy drugs) action, improvement of segmental allograft quality. Objective. To determine the indications
for allograft replacement of post-resection defects of long bones (and its types) in patients with malignant bone tumors. Methods.
Experimental studies were carried out to study morphological, biomechanical, biochemical changes in experimental rats after bone
allograft under different conditions. Using the finite element method, the tensely deformed conditions in the «allograft – recipientbone
– endoprosthesis» system were assessed to determine the most effective fixation technique of the bone allograft and recipient bone
in imitation of a bone regenerate in different terms after surgery. Results. The effectiveness of allograft prosthesis composite technique
with a step-cut osteotomy and additional bone autoplasty in the contact zone of the allograft and the recipient bone was proven.
It was determined that the use of radiation-sterilized bone allograft in combination with systemic administration of cytostatics leads to
inhibition of bone formation. We developed an algorithm-scheme of surgical treatment of patients with tumors of long bones using
segmental allograft and proposed methods of replacement of postresection bone defects for each localization of tumor lesions. Clinical
approbation was performed. Conclusions. Segmental bone allograft of large post-resection defects of long bones at their tumorous
affection remains an actual and perspective technique of one bioreconstruction. Clear adherence to the indications for this technique
will help to prevent complications and repeated operations.

Author Biography

Yanina Golovina, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Traumatology and Orthopaedics

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How to Cite

Golovina, Y. . (2023). A systematic approach to the surgical treatment of patients with long bone tumors using bone segmental alloimplants. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1-2), 26–33. https://doi.org/10.15674/0030-598720221-226-33

Issue

No. 1-2 (2022)

Section

ORIGINAL ARTICLES

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