Mohammad Ghareh Daghi - Orthopedic Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran
Mohammad Hassani - Department of Orthopedic Surgery, Orthopedic Research Centre, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran
Ali Parsa - Orthopedic Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran
Farzad Omidi-Kashani - Orthopedic Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran

Background: Limb salvaging surgeries are current surgical treatment of extremity bone sarcomas. Resected bonereplacement consists of two main methods; tumor prosthesis versus structural allograft. Biological reconstruction withan allograft is an economic cheap method in young sarcoma patients, however, the surgeons are more convinced withtumor prosthesis replacement.Methods: We evaluated the short-term complications and functional results of 40 patients with aggressive extremitytumors in a retrospective cohort study. The mean age of cases was 25 and we followed them for 24 months. 17patients underwent tumor prosthesis replacement after wide resection of limb sarcomas. 16 cases had structuralallograft reconstruction and 7 patients treated with amputation. We matched confounders including age, sex, bloodcell count and chemotherapy treatment in the study groups.Results: We found 15 major complications (45.5%) in limb salvage surgeries composing infection, allograft nonunion,allograft fracture, prosthesis fracture, prosthesis loosening and device failure that needed another surgery to beresolved. We had 10 major complications in allograft group (62%) and 5 in tumor prosthesis group (29.4%). Althoughthe rate of complications was higher in allograft group, it didn’t statistically indicate strong correlation (Fisher’s exact:0.084). Mean Musculo-Skeletal tumor rating Scale (MSTS) score was 25.8(73.7%) and 22.3(63.7%) in allograftgroup and prosthesis cases respectively. MSTS score had a normal distribution in the different groups with nosignificant difference between them.Conclusion: Although complications were higher in the allograft group, allograft could be offered to bone sarcomapatients, whom are predicted to have short life expectancy.Level of evidence: III

Allograft, Limb salvage, Sarcoma, Tumor prosthesis