American Association for Hand Surgery
Theme: Beyond Innovation

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Osteoarticular Allograft Reconstruction After Distal Radius Tumor Resection: Reoperation and Long-Term Patient Reported Outcomes
Jonathan Lans, MD1; Sarah Ballatori, BSc2; Rene M Castelein, MD PhD3; Neal C Chen, MD4; Santiago Lozano-Calderon, MD PhD2
1Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Massachusetts General Hospital/Harvard Medical School, Boston, MA, 2Department of Orthopaedic Oncology, Massachusetts General Hospital, Boston, MA, 3Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands, 4Massachusetts General Hospital, Boston, MA

Background: Osteoarticular allograft reconstruction is an option used to treat tumors of the distal radius. As most patients with a distal radius tumor are <50 years of age, the objective is to maintain long term function. Therefore, the aim of this study was to evaluate the postoperative and long-term patient reported outcomes after osteoarticular allograft reconstruction.

Methods: We retrospectively identified patients that underwent distal radius resection followed by osteoarticular allograft reconstruction from 1971 until 2015. We identified 33 patients with a giant cell tumor (n=27), osteosarcoma (n=4), chondrosarcoma (n=1) or leiomyosarcoma (n=1). Patient and treatment characteristics were collected through chart review. The median patient age was 32.4 years with a median chart follow up of 4.8 years. Ten patients were contacted to complete the Quick DASH, PROMIS-CA Physical Function and Toronto Extremity Salvage Score (TESS) at a median follow up of 20.6 years.

Results: Eighteen patients underwent reoperation of which 12 patients underwent wrist arthrodesis. The most common cause for reoperation was carpal subluxation and ulnar impaction. Two local giant cell tumor recurrences occurred. The patients that retained their allograft reported a median Quick DASH of 12.5 (IQR:4.5-42), a mean PROMIS physical function of 51.99.9 and a median TESS was 94.8 (IQR: 74.2-96.8).

Conclusion: Osteoarticular allograft reconstruction has a high revision rate, but patients seem to have favorable patient reported outcomes at long-term follow-up.

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