Allografts in reconstruction of osseous defects in primary malignant bone tumors

Reconstruction of large bone defects due to resection of musculoskeletal tumors can be performed with various types of massive homologous allografts. In combination with endoprostheses (composite allografts), various types of osteosyntheses, or autogenous vascularized grafts (most often the fibula), individual adaptation with respect to location, stability, and function is possible. In the elderly most often reconstruction with massive endoprostheses is performed; however, in younger patients limb-saving procedures using autologous material (e.g., rotationplasties) is the most acceptable procedure. Although allografts are of advantage with respect to better anatomic adaptation and thereby to function, the surgeon should be aware of potential drawbacks, especially late complications (fractures, graft resorption, and infection).