Incorporation of devitalised autografts in dogs

Böhm, Paul; Scherer, M. A.

doi:10.1007/s002640050170

Cited by 9 publications

(4 citation statements)

References 22 publications

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“…2,3,6,21 Both animal and in vitro human studies directly comparing autoclaving with irradiation indicated a superior biomechanical profile and better incorporation of the reimplanted bone with irradiation. 6,7,24 When cadaveric bone flaps are used for implantation, they are irradiated to extremely high doses in the range of 1000-40,000 Gy to destroy antigens as well as infectious agents. 20 However, this can also denature structural proteins, which can impair mechanical integrity and promote demineralization or resorption of the treated calvaria.…”

Section: Discussionmentioning

confidence: 99%

“…Animal studies utilizing intraoperative extracorporeal irradiation with lower doses have demonstrated excellent incorporation of the bone graft without structural integrity compromise. 7,26,32 Extracorporeal irradiation to sterilize tumorous autologous bone graft has been successfully used in malignant musculoskeletal tumors. However, to our knowledge, there is only 1 report utilizing this technique in neurooncological pathologies, 16 aside from our original prior case report.…”

Section: Discussionmentioning

confidence: 99%

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Extracorporeal irradiation of tumorous calvaria: a case series

Tavanaiepour

Broaddus

Chung

et al. 2015

JNS

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OBJECT When intracranial tumors invade the overlying skull, gross resection typically includes removal of the involved bone. Methods used to repair the resulting structural defect in the cranium include artificial prostheses, allogeneic bone grafts, and autoclaving the autologous graft. The authors have previously reported a case involving high-dose extracorporeal ionizing radiation to treat the tumorous calvaria intraoperatively, followed by reimplantation of the treated bone flap. In this paper the authors report the long-term follow-up of that case, as well as results of using extracorporeal irradiation of tumorous calvaria (EITC) for an additional 20 patients treated similarly. METHODS The decision to undergo EITC was typically anticipated preoperatively, but determined intraoperatively, if upon inspection the bone flap was invaded by tumor. The bone flap was then delivered to the radiation oncology department, where a total dose of 120 Gy was delivered, using a clinical linear accelerator, over a period of approximately 15 minutes. After the intracranial tumor resection was completed, the irradiated craniotomy bone flap was reimplanted and the wound was closed in a standard fashion. A retrospective review of patients who had undergone EITC was performed for evidence of calvarial tumor recurrence or other complications. RESULTS Since the originally reported case, 20 additional patients have received EITC during craniotomy for invasive tumors. Eighteen (86%) of 21 patients were diagnosed with meningioma: 12 (67%) with WHO Grade I, 5 (28%) with WHO Grade II, and 1 with WHO Grade III (6%). The remaining 3 patients presented with dural-based B-cell lymphoma with extensive adjacent bone invasion (n = 2) and metastatic adenocarcinoma of the lung (n = 1). Follow-up of the 21 patients ranged from 1 to 132 months, with a mean of 41 months and a median of 23 months. No patients have experienced tumor recurrence, infection associated with the treated calvaria, or evidence of bone flap resorption. CONCLUSIONS Calvaria reconstructions represent an important component in structural and cosmetic outcome following craniectomy for tumorous bone. The authors' long-term experience with EITC has been excellent with no local tumor recurrence or complications. Therefore, EITC represents an excellent and efficient option for cranial reconstruction in such patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Extracorporeal irradiation of tumorous calvaria: a case series

Tavanaiepour

Broaddus

Chung

et al. 2015

JNS

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“…When analyzing plain radiographs and skeletal scintigraphies during follow-up (Fig. Bony repair was more active after irradiation compared with autoclaving [11]. Whereas consolidation of the osteotomies was complete within a few months, the radiographic and scintigraphic signs of revitalization appeared much later.…”

Section: Discussionmentioning

confidence: 99%

“…Recently we reported our experience and reviewed the results of 106 cases published in the literature [6]. Animal experiments have shown better results with regard to the biomechanical properties and incorporation of the reimplanted bone when irradiation was used for extracorporeal devitalization than autoclaving [11]. Both disadvantages can be essentially reduced by using highdose irradiation instead of autoclaving.…”

Section: Introductionmentioning

confidence: 99%

Reimplantation of extracorporeal irradiated bone segments in musculoskeletal tumor surgery: clinical experience in eight patients and review of the literature

Böhm

Fritz

Thiede

et al. 2003

Langenbecks Arch Surg

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Background: Two methods are available for extracorporeally devitalizing resected tumor-bearing bone specimens, the simpler of which, autoclaving, has substantial disadvantages. We present our experience with the alternative reconstruction technique of reimplantating extracorporeally irradiated specimens (IEIR). Patients and methods: Eight patients who had primary malignant bone tumors of the long bones were managed with wide en bloc resection and IEIR. The segments were fixed by either plate osteosynthesis, knee arthrodesis rod, or intramedullary nailing. All seven patients with highgrade tumors received chemotherapy. Results: After a median follow-up of 66 months (40-76) five of eight patients were continuously free of disease. One man with a chondroblastic osteosarcoma developed pulmonary metastases which were resected. One woman with teleangiectatic osteosarcoma developed a local recurrence in the soft tissue without contact to the irradiated reimplant. At the latest follow-up, 58 months after resection of the pulmonary metastases and 28 months after resection of the locally recurrent tumor, there was no evidence of disease in either patient. Another woman 67 months after IEIR for an osteosarcoma of the distal femur developed a subcutaneous metastasis of the scalp and the thoracic wall and an ossifying pulmonary metastasis. At the time of writing she is receiving chemotherapy. After a median duration of 4.3 months (2.3-25.2) all grafthost junctions had healed. The functional result was good in four patients and excellent in the other four. Conclusions: Limb salvage using reimplantation of extracorporeally irradiated tumor-bearing bone segments for reconstruction offers an excellent reconstruction method in appropriately selected patients compared with other options of management.

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Methods of Biological Reconstruction for Bone Sarcoma: Indications and Limits

Kamtchouing

Bernd²

Treatment of Bone and Soft Tissue Sarcomas

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Incorporation of devitalised autografts in dogs

Cited by 9 publications

References 22 publications

Extracorporeal irradiation of tumorous calvaria: a case series

Extracorporeal irradiation of tumorous calvaria: a case series

Reimplantation of extracorporeal irradiated bone segments in musculoskeletal tumor surgery: clinical experience in eight patients and review of the literature

Methods of Biological Reconstruction for Bone Sarcoma: Indications and Limits

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