153640.fig.006a
(a)
153640.fig.006b
(b)
153640.fig.006c
(c)
Figure 6: In orthopaedic oncology, vascularised fibula transfer is considered as one of the most suitable techniques for the reconstruction of critically sized defects of the tibia diaphysis due to the mechanical strength, the predictable vascular pedicle, and the hypertrophic potential of the fibula. Combining the autograft with a large bone allograft can enhance the biomechanical properties of the construct. However, the use of allografts can be associated with significant drawbacks such as immunomediated rejection, graft sequestration or transmission of infectious diseases. In addition, the acquisition costs are rather high. A novel biological approach could be to combine an intramedullary fibular autograft with a customised tissue engineered bone construct. After tumor resection (a) a customised mPCL/TCP tube is placed around the vascularised fibula (b) to fill the defect. Together with an internal fixation device, it ensures load distribution and primary stability. Secondary stability is achieved by osseointegration of both the fibula and the porous scaffold (c).