Allograft Versus Prosthetic Reconstruction Outcomes Evaluated by Gait Analysis for Lower Extremity Bone Neoplasms Following Surgical Resection: a Systematic Review and Meta-analysis

Given that patients who suffer from extremity malignancies are primarily young, the validation and refinement of the management techniques for these type of tumors appear essential. Prosthetic reconstruction has already been established as a reliable surgical procedure for patients with lower limb bone neoplasms. Reconstruction with allograft has also been considered a viable treatment alternative for these patients, but evidence regarding the comparison of the efficacy between these techniques is scarce. The aim of this study is to evaluate and compare the impact of these two procedures on the gait parameters of patients that underwent lower limb tumor resection. The Medline, Scopus, and Cochrane databases were systematically scrutinized in January 2022. The outcomes of interest were gait parameters. Four studies were included in our analysis, from which three included allograft versus prosthetic reconstruction of the knee (distal femur or proximal tibia) and only one that evaluated the proximal femur. Compared to prosthetic reconstruction, allografts non-significantly increased gait velocity (0.04 m/s; 95% CI: − 0.03, 0.10; I 2 = 0%) and stride length (0.43% height; 95% CI: − 3.50%, 4.36%; I 2 = 27.7%), significantly increased cadence (4.12 stride/min; 95% CI: 1.40, 6.84; I 2 = 0%), and non-significantly reduced stance time (− 0.57% cycle time; 95% CI: − 1.16%, 0.02%; I 2 = 0%). Our results highlight the potential of allograft reconstruction and suggest that it should not be neglected as a valid treatment option with substantial functional outcomes, comparable to prosthetic reconstructive procedures. Larger studies are required to validate these conclusions.