[Massive allografts cold-preserved and radiation-sterilized].
Thirty massive bone allografts measuring between 7 and 30 centimeters and banked after freezing at -30 degrees centigrade and sterilization by Beta irradiation (2.5 to 3.5 megarads) were implanted. Ninety eight grafts were for reconstructions after a tumour resection and two were used for the treatment of femoral non-union and for reconstruction after removal of a prosthesis. In fifteen instances the only goal was to restore bone stability--six arthrodeses, seven replacements of diaphyseal or metaphyseal section and two iliac bone lesions. In fifteen other cases the aim was to preserve mobility (10 knees, 2 hips and 3 shoulders). Among these cases, a prosthesis was added in 9 knees and 2 hips and the graft was used alone in three shoulders and one knee. The average follow-up is too short to assess the incidence of recurrence, but it is long enough to note that there has been no case of post-operative infection. The authors considered that this is thanks to the use of sterilization by irradiation. Bone union was seen in 26 out of 30 cases at the diaphyseal--graft junction and in eight cases out of nine at the epiphyseal--graft junction. Three cases are pure diaphyseal replacements, did not unite. Two recurrent fractures of the graft at the third and fourth month united later. Scintigraphy showed that revascularization may take place after three months, thanks to the peripheral muscle which reattach to the graft spontaneously. This could be demonstrated by biopsy made during a second surgical procedure. A search for anti-HLA anti-bodies in the serum was positive on three occasions.