Structural Bone Allograft in Limb Salvage Surgery

THEORETICAL REVIEW

Abstract

Objective: Compile the most important medical bibliography on osseointegration, functionality and complications of the use of structural allograft in patients with bone defects of the appendicular skeleton who were subjected to a limb salvage surgery.

Material and method: A systematic search was carried out in order to find digital data that emphasized the research key words. These following digital search engines were consulted: Cochrane – PubMed – ScienceDirect, with concise inclusion and exclusion parameters

Results and discussion: 18 articles were included that fulfilled the established criteria of the study. The 83% were case series (CS) and the 17% were systematic reviews - meta-analysis (SR). The 15 articles of CS were validated with the MinCir scale with an average of 16.33 points (95%

Confidence interval: 14,39 and 18,27); and the 3 articles of SR were validated with the PRISMA scale with an average of 18.66 points (95% confidence

interval: 14,11 and 22,55); the 17% of the studies presented a level of evidence III, the 11% level III - IV and the remaining 72% level IV. The survival of bone reconstructions with the biological contribution was 88.14%, with a monitoring from 5 to 15 years, it had an excellent level of osseointegration, and functionality within normal limits. Among the most prevalent complications were mechanical, pseudoarthrosis and infections.  

Conclusions: The application of the structural bone allograft in conservative bone resections is considered beneficial in order to cover large bone defects, with an appropriate osseointegration and functionality. The associated complications can be avoided with the correct use of the clinical-surgical management protocols.