Biological reconstruction for extremity osteosarcoma: Pasteurized autogenous bone graft

Abstract

A pasteurization method has been previously developed with the aim of enabling reconstruction using diseased bones following resection of malignant bone tumors. Using this method, bone containing tumor cells is heat-treated at 60 °C for 30 min to kill the tumor and then transplanted into the same patient at the same location. This approach has distinct advantages for initial strength, anatomical fitting to the defect of the affected bone, no disease transmission, and good accessibility, including economic efficiency. We developed this pasteurization method and have used it in various graft forms since 1989. However, this method has been associated with pseudarthrosis in the short to middle term and bone resorption in the long term. Here we show its actual application and the results, with special focus on failure and long-term survival. Finally, we present an optimal indication for this method and clinical tips to reduce its failure.