Improvement of massive bone allograft selection using 3D-CT-registration

Massive bone allograft selection is generally based on radiographs comparison of the allograft with those of the patient. Some mismatch can persist, leading to poor host-allograft contact or poor reconstruction stability with potential non-union or fracture. A method based on registration is presented to optimize the matching between allograft and patient's bone. CT-based 3D-registration was used in six cases to help the surgeon in the choice of the best massive allograft. Good matching was obtain in five cases and only suboptimal matching in the sixth due to the lack of allograft availability. In all cases good primary stability of the construct was obtained and allowed early weight bearing of the patient. Preoperative registration of available bone allografts and patient's host bone is a promising tool in limb reconstruction surgery.