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LONG TERM FOLLOW UP OF MASSIVE OSTEOCHONDRAL ALLOGRAFT TRANSPLANTATION in BONE TUMORS

 

 

PATIENT DETAILS CASE - 2

C.S, THAI MALE, 9 YEARS OLD ON 1st November 1989

DIAGNOSIS : Fibrous Dysplasia of left Shaft of Tibia

FIRST OPERATION: Tumor resection + replacement with deep frozen Intercalary mid shaft humerus allograft

DATE OF 1st SURGERY: 24th November 1989

DATE OF 2nd SURGERY: 7TH JULY 1997

SECOND OPERATION: Removal of Internal Fixation and biopsy at Host-Allograft Junction

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PRE-OP X-RAY SHOWING FIBROUS DYSPLASIA AT MID SHAFT TIBIA TUMOR LESION BEING RESECTED

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SPECIMEN OF TUMOR AFTER RESECTION ALLOGRAFT BEING TAKEN FOR SIZING

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ALLOGRAFT SIZED MORSELLIZED BONE ALLOGRAFT MIXED WITH PATIENT BLOOD

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ALLOGRAFT FIXED WITH PLATE SCREW ALLOGRAFT AND INTERNAL FIXATION COMPLETE

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POST -OPERATIVE X-RAY AND PATIENT, 7 YEARS 2 MONTHS

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POST-OPERATIVE 7 YEARS 2 MONTHS POST-OPERATIVE AFTER REMOVAL OF IMPLANT, 7 YEARS 2 MONTHS

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BIOPSIES FROM BILATERAL ENDS REVEAL COMPACT LAMELLAR BONE WITH OSTEOCYTES IN LACUNAE. THE DISTAL END EXHIBITS BONE RESPORTION OF THE TRABECULAE WITH MULTINUCLEATED GIANT CELLS OF OSTEOCLASTS THE MIDDLE ZONE ILLUSTRATES BONE GRAFT WITHOUT INFLAMMATORY REACTION. THE BONE MATRIX RETAINS LAMELLAR TEXTURE WITH SCATTERED EMPTY LACUNAE. PERIOSTEUM IN NOT DISTINCT.

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POST - OPERATIVE 10 YEARS 10 MONTHS

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POST - OPERATIVE 10 YEARS 10 MONTHS

 

DISCUSSIONS

BONE INCORPORATION IS NOTED IN THE PHERIPHERY OF THE ALLOGRAFT AND SEEMS SLOWLY TO BE CREEPING IN THE CENTER OF THE ALLOGRAFT.

IMPLANT REMOVAL WAS DONE SO AS TO RELEASE THE STRESS CONCENTRATION POINTS ON THE ALLOGRAFT

KNEE JOINT IS PERFECT

CARTILAGE SEEMS TO BE PERFECT

NO PAIN OR INFECTION

 

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