BONE RECONSTRUCTION PROCEDURE USING TUMOR BEARING
AUTOGRAFT AFTER BONE RECYCLING USING LIQUID NITROGEN
A Case Series
Arrisna Artha*, Eka Wiratnaya**
*Resident of Orthopaedi and Traumatology Department-University of Udayana/ Sanglah General Hospital Denpasar
**Oncology Staff of Orthopaedi and Traumatology Department-University of Udayana/ Sanglah General Hospital Denpasar
Background. Advances in diagnostic imaging, neoadjuvant chemotherapy, and operative technique have made it possible to treat malignant tumours of bone and soft tissue by limb salvage. With multidisciplinary treatment, such techniques produce a functional and durable limb without reducing the long-term results. All the established methods of reconstruction such as the use of massive prostheses, allografts, combinations of allografts and prostheses or with bonecement have made limb salvage possible.
Method. We describe a method of reconstruction using tumour-bearing autograft treated by liquid nitrogen in 3 patients. The operative technique consisted of en bloc excision of the tumour, removal of soft tissue, curettage of the tumour, bone recycling using liquid nitrogen, drilling and preparation for internal fixation or prosthetic replacement. Bone graft or cement was used to augment bone strength when necessary. Outcomes were assessed through Revised Musculoskeletal Tumour Society Rating Score.
Result. From three patients with musculoskeletal tumour we already treated using liquid nitrogen, two patients gave a positive respond to this treatment, while one patient has a local recurrence. Our results suggest that this is a simple and effective method of biological reconstruction
Conclusion. The effectiveness of this reconstruction technique in properly selected patients with malignant bone tumor. Reconstruction with tumour-bearing massive frozen autograft treated by liquid nitrogen in malignant bone and soft-tissue tumours is a simple and effective method of biological reconstruction. Long-term follow-up studies will provide more useful information and clarify the effectiveness of this study.
