Patients who underwent the Capanna technique for intercalary reconstruction after tumor resection had a lower complication rate and higher success rate compared with use of an allograft or a vascularized fibular graft alone, according to published results.
Researchers performed a multivariable linear, multiple regression model analysis for 60 patients who underwent segmental reconstruction with use of the Capanna technique following tumor resection in which allograft-host osseous union time was the dependent variable. Researchers evaluated radiographs for union time and histologically assessed a retrieved specimen of the composite. Age, tumor site, adjuvant treatment, a previous surgical procedure, defect length, fixation method and fibular viability were considered independent variables.
Results showed patients had a mean defect length of 16 cm and union occurred among all allografts and host bone at a mean time to union of 13 months. Although devitalization of the fibular graft, use of chemotherapy and a previous surgical procedure were associated with prolonged time to union, researchers found no association between union time and patient age, amount of resection, operative site and fixation method. Histological analysis showed callus from both periosteum of the host bone and the fibula united the allograft-host cortical junction.
“Patients with adverse factors should be closely observed during the healing process; in such a scenario, extended immobilization and delayed weight-bearing are advised,” the authors wrote. “In most cases, osseous union still could be achieved even in the presence of those adverse factors.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.