BONE QUALITY EVALUATION IN ALLOGRAFT HAND TRANSPLANT

Christophe Rizzo¹, Vincent Guigal¹, Jean Baptiste Pialat², Nicolas Vilayphiou³, Emmanuel Deshayes⁴, Aram Gazarian^1,5.

¹Département de Chirurgie de la Main, Clinique du Parc; ²Service de Radiologie, Hôpital Edouard Herriot; ³Inserm 831, Hôpital Edouard Herriot; ⁴Service de Médecine Nucléaire, Hôpital Edouard Herriot; ⁵Service de Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon, France.

Five bilateral forearms allograft have been performed between January 2000 and July 2009 in Lyon (France). The first four patients (three males, one female) have been the subject of an assessment of the bone quality of those allografts. The techniques selected for this study were : radioclinical analysis, bone scintigraphy, MRI, bone densitometry and High Resolution peripheral Quantitative Computer Tomography (HR-PQCT). On the clinical, radiological and scingraphical aspects, donor bone integration in hands allograft are good on a macroscopic point of view considering the healing and the general reaction of the bone in situation of fractures, infection and growth. The scintigraphy does not show important variations compared to the one we can observe on contact with osteosynthesis material or during bone autografts. MRI found neither focal nor periosteal anomaly on grafted bone. The bone densitometry did not show significant difference with secondary osteoporosis one can observe in other grafted patients under immunosuppressive treatment. The HR-PQCT showed for the three males patients, a higher loss in volumetric density, for grafted bone than in the recipient patient control skeleton. Due to the small number of patients in this series and the discrepancies in follow-up duration, the present datas have to be confirmed with further studies.