Combination of Extracorporeally-irradiated Autograft and Vascularized Bone Graft for Reconstruction of Malignant Musculoskeletal Tumor

Background: Reconstruction after wide resection of a malignant musculoskeletal tumor is challenging. We performed biological reconstruction with an extracorporeally-irradiated autograft in combination with a vascularized bone graft. Patients and Methods: Fifteen patients who underwent curative resection of malignant musculoskeletal tumor followed by reconstruction with this method were included. Oncological outcomes, survival of the graft, radiological findings and functional outcomes were reviewed. Results: No local recurrences were detected from the irradiated bones, and 93% of the vascularized bone grafts survived. The mean MSTS score was 24.8 in all cases, 22.9 in the osteoarticular cases, and 27 in the intercalary cases. The intercalary tibia cases showed excellent results with a mean MSTS score of 29.3. Conclusion: This method has the advantage of combining the mechanical quality of an irradiated autograft and biological quality of a vascularized bone graft. The best indication of this method is for intercalary defects of the tibia.