A comparison of tumor prosthesis implantation and pasteurized autograft-prosthesis composite for proximal tibial tumor.

BACKGROUND AND OBJECTIVES: Although previous reports on composite biologic reconstruction in the proximal tibial location vary, we hypothesized that this type of reconstruction may reduce the late infection rate and have advantages in terms of longevity by restoring bone stock. METHODS: Primary analysis addressed differences between 62 tumor prosthesis (TP) and 25 pasteurized autograft-prosthesis composite (PPC) reconstructions in terms of survival rates, functional outcomes, and temporal patterns of infection. RESULTS: The 10-year survival rates of the TP and PPC groups were 73.9 ± 11.7 and 68.7 ± 20.1 %, respectively (P = 0.64). Reconstructive failure occurred in 16 (25.8 %) in the TP and in 7 (28 %) in the PPC group. The cause of failures in the TP group was infection (16), whereas those of PPC group were infection (5), loosening (1), and local recurrence (1). The mean functional scores of TP (52) and PPC (20) patients that maintained a mobile joint were 24.2 (81 %) and 25.1 (83.6 %), respectively. Infection rates in the two groups were similar (P = 0.328), but infections occurred earlier in the PPC group (P = 0.011). CONCLUSIONS: This comparative study suggests composite biological reconstruction shows a comparable long-term survival rate to TP reconstruction; however, the composite method has a tendency to a lower rate of late infection.