Extracorporeally irradiated autograft-prosthetic composite arthroplasty using AML extensively porous-coated stem for proximal femur reconstruction: a clinical analysis of 14 patients.

BACKGROUND AND OBJECTIVES: Allograft-prosthetic composite for reconstruction of the proximal femur after tumor excision is widely used as an alternative to megaprosthesis. To achieve greater biological fixation, we employed a long-stem prosthesis that is cemented proximally into the extracorporeally irradiated autograft and press-fit distally into the host femur without any supplementary plate fixation of the junction instead of the standard all-cemented technique. METHODS: From 1997 to 2002, 14 patients underwent proximal femur reconstruction with extracorporeally irradiated autograft-prosthetic composite using an AML extensively porous-coated long stem for reconstruction of the bone defect of tumor excisions. RESULTS: At the mean follow-up period of 65.7 months, only one patient (8.1%) developed non-union and another died of disease before union of the junction. The remaining 12 patients (85%) achieved union at a mean of 20.3 weeks (range, 14-40 weeks) without major complication. The mean functional Enneking score was 72.1% (range, 53-93%). CONCLUSIONS: These clinical results show that this reliable and satisfactory technique promotes union through compression at the host-graft junction with weight-bearing by leaving the distal portion of the femoral stem uncemented into the host bone.

Synthesis of Substituted Benzenes via Bi(OTf)3-Mediated Intramolecular Carbonyl Allylation of α-Prenyl or α-Geranyl ß-Arylketosulfones.

Intramolecular carbonyl allylation of α-prenyl or α-geranyl ß-arylketosulfones 5 in the presence of molecule sieves (MS) affords substituted benzenes 6-7 in moderate to good yields. The facile transformation proceeds by a synthetic sequence starting with the α-prenylation or α-geranylation of 1 and the Bi(OTf)3-mediated annulation of 5 followed by a sequential desulfonative aromatization or then an intramolecular Friedel-Crafts alkylation. A plausible mechanism has been studied and proposed.