Table 2.
Multiple complications necessitated subsequent surgical interventions
| Patient number | Conversion time (months) | Allograft preserved | Treatment | Complication after conversion | Total graft survival (months) |
|---|---|---|---|---|---|
| Progressive joint degeneration | |||||
| 8 | 31 | No | Conversion to APC | Allograft fracture (44)* | 44 |
| 9 | 156 | Yes | Conversion to APC | Patellar clunk | 283 |
| 10 | 47 | Yes | Conversion to APC | None | 182 |
| 11 | 99 | Yes | Conversion to APC | None | 194 |
| 12 | 39 | No | Conversion to APC | Allograft fracture (55)* | 55 |
| 13 | 133 | No | Conversion to APC | Instability† | 186 |
| 14 | 100 | Yes | Conversion to APC | None | 238 |
| 16 | 212 | Partial | Conversion to Mega‡ | None | 212 |
| Patient number | Initial soft tissue coverage | Infection | Time to presentation | Allograft preserved | Treatment | Final outcome |
|---|---|---|---|---|---|---|
| Infection | ||||||
| 19 | None | Deep | 30 months | No | 2-stage exchange | Limb preservation |
| 20 | Local flap§ | Deep | 20 days | Yes | N/A** | Limb preservation** |
| 21 | None | Superficial | 2 months | Yes | Local flap, STSG | Limb preservation |
| 22 | Local flap|| | Superficial | 2 weeks | Yes | Wound revision | Limb preservation |
| 23 | Local flap¶ | Superficial → deep | 20 days | No | 2-stage exchange | Limb preservation |
| 24 | None | Deep | 114 months | No | 2-stage exchange | Limb preservation |
| Patient number | Time to intervention | Treatment | Final outcome |
|---|---|---|---|
| Nonunion | |||
| 15 | 13 months | Exchange nail | Union |
| 16 | 24 months | Vascularized fibula | Union |
| 17 | 19 months | ICBG; exchange nail (second surgery) | Union |
| 19 | 9 months | ICBG | Developed infxn†† |
| 23 | 11 months | Exchange nail | Developed infxn†† |
| Patient number | Type of implant | Treatment | Allograft preservation |
|---|---|---|---|
| Fracture | |||
| 8 | Nail | Revised APC (new allograft) | No |
| 12 | Plate | Revised APC (new allograft) | No |
| 19 | Nail | Revised to new OA allograft | No |
| 24 | Plate | ORIF fracture | Yes |
| 25 | Nail | Revised APC (new allograft) | No |
| Patient number | Time from initial surgery (months) | Allograft preserved | Treatment | Final outcome |
|---|---|---|---|---|
| Resorption | ||||
| 16 | 24 | Yes‡‡ | Vascularized fibula§§ | Resorption halted |
*Conversion to APC (new allograft); †conversion to mega-prosthesis; ‡megaprosthesis; §sartorius; ||gracilis; ¶gastrocnemius; **patient died before explantation; ††developed infection; ‡‡later developed degenerative joint disease; §§see Fig. 4; APC = allograft-prosthesis composite; STSG = split-thickness skin graft; OA = osteoarthritis; ORIF = open reduction and internal fixation.