Allograft reconstruction uses donor bone (from a bone bank) to replace a segment of bone removed during tumour surgery. It provides a biological scaffold that can incorporate with the patient's own bone over time.
After tumour resection, a matched donor bone segment (stored frozen in a bone bank) is shaped to fit the defect. It is fixed with plates, screws, and/or an intramedullary nail. The host bone gradually grows into the allograft over months to years. Soft tissues and tendons can be reattached to the allograft. The operation adds one to two hours to the resection.
Allograft reconstruction is preferred in young patients where biological reconstruction offers the possibility of long-term integration without the lifelong revision burden of metal implants. It is particularly useful for intercalary (mid-shaft) defects where the joints at each end are preserved.
Endoprosthetic reconstruction, vascularised bone graft, or amputation.
Size-matched allograft sourced from a certified bone bank. The allograft is screened for infection and disease.
Biological reconstruction that can incorporate and last a lifetime. Allows tendon and ligament reattachment. Particularly advantageous in growing children.
Allograft healing is slow — full incorporation takes one to three years.
Prolonged restricted weight-bearing is needed.
The allograft may fracture before or during incorporation. Risk approximately 15-20%.
Failure of the junction between allograft and host bone to heal.
Risk approximately 10-15% — higher than endoprosthesis due to the avascular nature of allograft.
The allograft may be gradually resorbed by the body.
Extremely rare with modern screening.
General anaesthesia. Part of a larger tumour resection procedure.
Protected weight-bearing for six to twelve months depending on incorporation. Physiotherapy throughout. Full incorporation at one to three years.
Regular X-rays and oncology surveillance. Long-term monitoring of graft incorporation.
From a registered bone bank. Donors are carefully screened and the bone is processed and stored frozen. The risk of disease transmission with modern screening is extremely low.