Abstract:

Allogeneic bone transplantation is a commonly used method for repairing bone defects， but its long-term complications such as pathological bone resorption remain insufficiently understood in clinical practice. This article reported a rare case of progressive bone resorption occurring 2 years after allogeneic bone transplantation for calcaneal fracture， discussed its diagnostic and therapeutic strategies， and reviewed the relevant literature. The patient， a 48-year-old male， underwent open reduction and internal fixation with primary implantation of allogeneic bone graft for bilateral calcaneal fractures 7 years ago， and developed pain in both heels in the second postoperative year， which progressively worsened annually. Imaging examinations revealed extensive cavitary bone defects in both calcanei， accompanied by osteomyelitis-like changes. Intraoperative exploration identified abundant light yellow serous fluid， sandy bone debris， and granulation tissue within the calcanei. Postoperative pathological examination showed chronic inflammatory cell infiltration in the lesion， with negative bacterial culture， confirming the diagnosis of chronic aseptic osteomyelitis. After thorough debridement， the bone defect was reconstructed with autologous iliac bone grafting. The 6-month postoperative follow-up showed that the symptoms of the patient were significantly improved， and CT examination revealed favorable osseointegration in the bone-grafted area without signs of resorption. Delayed， progressive bone resorption may occur after allogeneic bone transplantation， and thorough removal of inflammatory lesions combined with autologous bone reconstruction can be an effective treatment for this complication.

Key words: Allogeneic bone, Calcaneal fracture, Aseptic osteomyelitis, Bone resorption, Case report