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01.12.2012 | Research | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Limb salvage in osteosarcoma using autoclaved tumor-bearing bone

World Journal of Surgical Oncology > Ausgabe 1/2012
Kok Long Pan, Wai Hoong Chan, Gek Bee Ong, Shanmugam Premsenthil, Mohammad Zulkarnaen, Dayangku Norlida, Zainal Abidin
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-105) contains supplementary material, which is available to authorized users.

Competing interests

All authors declare that they have no competing interests.

Authors’ contribution

KLP was the main surgeon. WHC was the second surgeon. GBO gave chemotherapy for pediatric patients. SP gave chemotherapy for adult patients and also radiotherapy. MZ, DN and ZA red the histological slides before and after the surgical resections. All authors’ read and approved the final manuscript.



Tumor prostheses currently give the best short- and medium-term results for limb-salvage reconstruction procedures in the treatment of bone tumors. However, in developing countries, the cost of a tumor prosthesis is beyond the reach of much of the population. We report the use of autoclaved tumor-bearing bone in 10 patients, as an affordable alternative to the use of prostheses.


This is a case series of 10 patients (mean age 19 years) with osteosarcoma who were treated at our hospital from 1998 to 2008, and followed up for a mean of 35 months (range 14 to 8). The femur was involved in six cases, the humerus in three cases, and the ulna in one case. The mean length of the autoclaved bone was 150 mm (range 60–210).


Bone union occurred in seven patients over an mean duration of 12 months (range 8–17). Three patients had non-union. Two of these had associated implant failure, with one of them also developing chronic infection, and the third is still being followed up. Two other patients had local recurrence.


The use of autoclaved tumor grafts provides an inexpensive limb-salvage option without sacrificing appropriate oncologic principles. A painless and stable limb is achievable, and the use of this technique can be further refined.
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