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Introduction <p>In the present era, biological reconstruction as an adjunct to limb salvage to treat non-metastatic malignant bone tumors includes autografts or allografts. Devitalized tumor-bearing autograft using liquid nitrogen as a modality for reconstruction following tumor excision is one of the viable options of limb salvage with multiple advantages and no risk of transmission of infection and graft rejection, unlike allografts. To the best of our search, there is a lack of literature that has compiled studies related to the treatment of malignant bone tumors with liquid nitrogen. Here in this systematic review and meta-analysis, we have tried to analyze the treatment of malignant bone tumors with respect to oncological outcomes, union time following fixation, functional scores achieved, and associated complications.</p> Materials and Methods <p>Pubmed, Scopus, and Embase databases were searched till 31st March 2024, which included all original studies which used liquid nitrogen as an adjunct to treat non-metastatic primary malignant bone tumors.</p> Results <p>A total of 21 original studies were selected. The meta-analysis of oncologic outcomes indicated that the highest proportion of patients achieved disease-free status at the mean follow-up, with the mean bone union time being 7.81&#xa0;months and average functional outcomes score (MSTS score) being 81.8%. The average complication per patient rate was 0.48, of which structural failure was the most common type of complication noted following usage of liquid nitrogen-treated autograft.</p> Conclusion <p>Liquid nitrogen has long been employed in the management of malignant bone tumors; however, its potential remains underutilized. The technique of using liquid nitrogen to sterilize autografts has shown promising results, particularly in resource-limited settings where radiotherapy facilities are not readily available. Over time, biological grafts have demonstrated superior long-term outcomes compared to endoprosthesis, which carry inherent limitations. Nevertheless, treatment decisions should be tailored to individual clinical scenarios, patient preferences, and institutional capabilities.</p>

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Oncological and Functional Outcome of Cryoablated Autografts in Malignant Bone Tumor Reconstruction: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年12月8日

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  • Vikas Maheshwari,
  • Parshwanath Bondarde,
  • V. Danish,
  • Biswa Bandhu Niraula,
  • Mohit Dhingra,
  • Karuppusami Reka

摘要

Introduction

In the present era, biological reconstruction as an adjunct to limb salvage to treat non-metastatic malignant bone tumors includes autografts or allografts. Devitalized tumor-bearing autograft using liquid nitrogen as a modality for reconstruction following tumor excision is one of the viable options of limb salvage with multiple advantages and no risk of transmission of infection and graft rejection, unlike allografts. To the best of our search, there is a lack of literature that has compiled studies related to the treatment of malignant bone tumors with liquid nitrogen. Here in this systematic review and meta-analysis, we have tried to analyze the treatment of malignant bone tumors with respect to oncological outcomes, union time following fixation, functional scores achieved, and associated complications.

Materials and Methods

Pubmed, Scopus, and Embase databases were searched till 31st March 2024, which included all original studies which used liquid nitrogen as an adjunct to treat non-metastatic primary malignant bone tumors.

Results

A total of 21 original studies were selected. The meta-analysis of oncologic outcomes indicated that the highest proportion of patients achieved disease-free status at the mean follow-up, with the mean bone union time being 7.81 months and average functional outcomes score (MSTS score) being 81.8%. The average complication per patient rate was 0.48, of which structural failure was the most common type of complication noted following usage of liquid nitrogen-treated autograft.

Conclusion

Liquid nitrogen has long been employed in the management of malignant bone tumors; however, its potential remains underutilized. The technique of using liquid nitrogen to sterilize autografts has shown promising results, particularly in resource-limited settings where radiotherapy facilities are not readily available. Over time, biological grafts have demonstrated superior long-term outcomes compared to endoprosthesis, which carry inherent limitations. Nevertheless, treatment decisions should be tailored to individual clinical scenarios, patient preferences, and institutional capabilities.