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Figure 4. Flowchart of the systematic literature search (*excluded languages were Chinese, Spanish, Russian and Norwegian; †including (but not limited to) basic science studies, animal studies, reviews without new cases, radiological studies, immunological studies and biomechanical studies; ‡excluded sites involving the pelvis, hand and elbow; ¶excluded indications were traumatic skeletal defects and failed arthroplasty).
Predominant reconstruction sites were the distal femur (n = 333, 43%), proximal tibia (n = 228, 29%), proximal humerus (n = 111, 14%) and distal radius (n = 100, 13%). To ensure that complications could be linked to the site at which they occurred, we selected only those papers that reported on one reconstruction site exclusively. We identi ed three papers focusing on the distal femur (n = 184)14, 16, 19, ve on the proximal tibia (n = 136)15, 17, 43, 47, 53, seven on the distal radius (n = 99)22, 38, 40, 41, 48-50 and ve on the proximal humerus (n = 95)21, 23, 24, 45, 46, leaving 514 reconstructions for analysis. Apart from one study that included 18% unicondylar distal femoral reconstructions14, all reconstructions were segmental.
Osteoarticular allografts
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