Department of Orthopaedic Surgery, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
Arch Orthop Trauma Surg. 2012 Dec;132(12):1685-95. doi: 10.1007/s00402-012-1606-4. Epub 2012 Aug 25.
Pasteurized autografts used in limb salvage operations for malignant musculoskeletal tumors have several advantages, including reduced disease transmission, economic efficiency, accessibility, and anatomical conformation. However, their use has been associated with bone absorption, fracture, and pseudarthrosis. Few studies exist which have assessed the long-term outcomes of pasteurized autografts. The purpose of this study was to investigate the clinical outcomes of patients treated with pasteurized autografts and to compare these outcomes across various graft types.
A retrospective analysis of 46 patients treated with pasteurized autografts between 1992 and 2010 was conducted. The analysis included 22 intercalary bone grafts, 17 inlay grafts, 4 composite grafts, and 3 osteochondral grafts, with the mean follow-up period of 8.7 years (2-17 years).
The 10-year survival rate of the 46 pasteurized autograft cases analyzed was 93.5 %, and the average bone union time between host and pasteurized autogenous bone was 9.5 months. Infections were identified in 6 (13 %) patients, fractures in 7 (15 %) patients, non-union in 8 (17 %) patients, and bone absorption in 6 (13 %) patients. Inlay grafts were completely incorporated with the host bone at the follow-up period. Combination with a vascularized fibular graft significantly reduced the risk of non-union and bone absorption (p < 0.05 and p < 0.01, respectively), with an average functional score of 23.1/30 (83.8 %).
Our findings show that pasteurized bone grafts in combination with vascularized fibular grafts have improved outcomes and potential clinical indications.
在保肢手术中使用巴氏消毒的自体移植物有几个优点，包括降低疾病传播、经济效率、可及性和解剖形态。然而，它们的使用与骨吸收、骨折和假关节有关。目前，很少有研究评估巴氏消毒自体移植物的长期结果。本研究旨在探讨接受巴氏消毒自体移植物治疗的患者的临床结果，并比较不同移植物类型的结果。
对 1992 年至 2010 年间接受巴氏消毒自体移植物治疗的 46 例患者进行回顾性分析。分析包括 22 例节段性骨移植物、17 例镶嵌式移植物、4 例复合移植物和 3 例骨软骨移植物，平均随访时间为 8.7 年（2-17 年）。
分析的 46 例巴氏消毒自体移植物病例的 10 年生存率为 93.5%，宿主与巴氏消毒自体骨之间的平均骨愈合时间为 9.5 个月。6 例（13%）患者发生感染，7 例（15%）患者发生骨折，8 例（17%）患者发生骨不连，6 例（13%）患者发生骨吸收。镶嵌式移植物在随访期内完全与宿主骨融合。与带血管腓骨移植相结合显著降低了骨不连和骨吸收的风险（p<0.05 和 p<0.01），平均功能评分为 23.1/30（83.8%）。
我们的发现表明，巴氏消毒骨移植物与带血管腓骨移植相结合可改善结果并具有潜在的临床适应证。
