Page 230 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Chapter 11
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Table 2. Classi cation of complications for biological reconstructions (allograft, autograft) in orthopaedic oncology
Category
Type
Subtype
Description
Time of diagnosis1
No. of patients a ected2
No. of patients needing a re- intervention
No. of grafts removed as a result
Mechanical
Type 1: Soft tissue
1A. Functional 1B. Coverage
2A. Hypertrophic
Instability or dislocations (including dislocations treated with closed or open reduction)
Non-mechanical
Type 4. Infection3
4A. Acute
4B. Late or chronic 4C. Secondary acute 5. Local tumor relapse
<6 weeks after implantation
>6 weeks after implantation
<6 weeks after secondary procedure Recurrence or progression of tumor
Type 2: Nonunion
Hypertrophic nonunion of the allograft-host junction, de ned as the lack of continuity in three cortices at the junction one year after surgery
Type 3: Structural failure
3A. Fracture
Fracture of graft or fracture through graft-host junction
Type 5. Tumor progression
2B. Atrophic
Atrophic nonunion of the allograft- host junction, de ned as the lack of continuity in three cortices at the junction one year after surgery
3B. Hardware breakage
Breakage of osteosynthesis material
3C. Graft collapse or massive resorption
Collapse of the graft, of massive resorption of the graft
Super cial wound problems, including aseptic wound dehiscence and super cial necrosis
1 Report the median time (and range) from surgery to diagnosis of the complication, in months. Does not apply for a type 2 complication (nonunion) 2 Report the total number of patients who were a ected by the complication, also those who did not need surgical re-intervention
3 All deep infections, including those treated with graft retention