Osteoarticular allograft reconstruction after resection of the distal radius : survival and functional results at ten to 24 years follow-up.

Aims: Various reconstructions of the distal radius after tumour resection have been proposed. Osteoarticular allografts can restore a functional joint, but the long-term durability of this reconstruction has been questioned. Data on long-term results are scarce in the literature. The aim of our study was to answer the following questions: What is the long-term survival of osteoarticular distal radius allografts with a minimum follow-up of ten years? What is the long-term patient satisfaction? Methods: From 1999 to 2013, we performed 23 reconstructions with osteoarticular allografts after distal radius resection. Patients had a mean age of 36 years (14 to 69); 17 had giant cell tumour, three Ewing's sarcoma, two osteosarcoma, and one osteoblastoma. All patients were evaluated for allograft survival and functional outcome (Musculoskeletal Tumor Society (MSTS) score and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire score). Results: One patient was lost to follow-up at 53 months. One patient died for concomitant disease at 44 months. Of the remaining 21 patients, one underwent revision arthrodesis at 48 months. A total of 20 allografts remained in situ at follow-up for a mean of 213 months (22 to 293). The mean MSTS was 25.7 (18 to 30), and the mean DASH was 10.4 (0 to 30). According to the MSTS parameter of emotional acceptance, all patients with a surviving allograft scored still satisfied or higher. Conclusion: In our experience, osteoarticular allografts in distal radius reconstruction can be a long-lasting procedure with long-term patient satisfaction. Few and conflicting results are reported in the literature; even when comparing series, it is difficult to clearly identify factors that may explain the differences in reported results.