LONG TERM FOLLOW UP OF MASSIVE OSTEOCHONDRAL ALLOGRAFT TRANSPLANTATION in BONE TUMORS
PATIENT DETAILS CASE - 2
C.S, THAI MALE, 9 YEARS OLD ON 1st November 1989
DIAGNOSIS : Fibrous Dysplasia of left Shaft of Tibia
FIRST OPERATION: Tumor resection + replacement with deep frozen Intercalary mid shaft humerus allograft
DATE OF 1st SURGERY: 24th November 1989
DATE OF 2nd SURGERY: 7TH JULY 1997
SECOND OPERATION: Removal of Internal Fixation and biopsy at Host-Allograft Junction
| PRE-OP X-RAY SHOWING FIBROUS DYSPLASIA AT MID SHAFT TIBIA | TUMOR LESION BEING RESECTED |
| SPECIMEN OF TUMOR AFTER RESECTION | ALLOGRAFT BEING TAKEN FOR SIZING |
| ALLOGRAFT SIZED | MORSELLIZED BONE ALLOGRAFT MIXED WITH PATIENT BLOOD |
| ALLOGRAFT FIXED WITH PLATE SCREW | ALLOGRAFT AND INTERNAL FIXATION COMPLETE |
| POST -OPERATIVE X-RAY AND PATIENT, 7 YEARS 2 MONTHS |
| POST-OPERATIVE 7 YEARS 2 MONTHS | POST-OPERATIVE AFTER REMOVAL OF IMPLANT, 7 YEARS 2 MONTHS |
| BIOPSIES FROM BILATERAL ENDS REVEAL COMPACT LAMELLAR BONE WITH OSTEOCYTES IN LACUNAE. THE DISTAL END EXHIBITS BONE RESPORTION OF THE TRABECULAE WITH MULTINUCLEATED GIANT CELLS OF OSTEOCLASTS | THE MIDDLE ZONE ILLUSTRATES BONE GRAFT WITHOUT INFLAMMATORY REACTION. THE BONE MATRIX RETAINS LAMELLAR TEXTURE WITH SCATTERED EMPTY LACUNAE. PERIOSTEUM IN NOT DISTINCT. |
| POST - OPERATIVE 10 YEARS 10 MONTHS |
| POST - OPERATIVE 10 YEARS 10 MONTHS |
DISCUSSIONS
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BONE INCORPORATION IS NOTED IN THE PHERIPHERY OF THE ALLOGRAFT AND SEEMS SLOWLY TO BE CREEPING IN THE CENTER OF THE ALLOGRAFT. |
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IMPLANT REMOVAL WAS DONE SO AS TO RELEASE THE STRESS CONCENTRATION POINTS ON THE ALLOGRAFT |
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KNEE JOINT IS PERFECT |
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CARTILAGE SEEMS TO BE PERFECT |
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NO PAIN OR INFECTION |