A 13-year-old girl undergoes limb salvage for proximal humeral osteosarcoma using a massive osteoarticular allograft rather than a metal endoprosthesis. Which complication is specific to this biological reconstruction and does not occur with a metallic prosthesis?

• A Deep infection of the reconstruction
• B Limb length discrepancy during growth
• C Requirement for lifelong immunosuppressive therapy
• D Degeneration and collapse of the transplanted articular cartilage ✓

Explanation

An osteoarticular allograft transfers living-appearing but avascular articular cartilage, which gradually degenerates and can lead to subchondral collapse and joint incongruity; this failure mode is impossible with a metal prosthesis. Deep infection occurs with both reconstructions. Massive allografts are stored frozen and are not immunosuppressed against, and limb length issues relate to growth arrest from resection or the implant chosen, not specifically to the allograft cartilage.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.