This study aimed to retrospectively analyze the follow-up results of cases in which the adjacent joint was preserved using a custom-made uncemented short-stem design (hollow stem) with optional external flanches in tumor endoprosthetic replacement due to bone sarcomas in 13 patients (with an average age of 9.6 years) between 2017 and 2023. Reconstructions were proximal femur ( = 6), intercalary femur ( = 4), intercalary tibia ( = 2), and proximal humerus ( = 1) tumor prostheses. The hollow body was used distally in 10 of the megaprotheses, proximally in 1, and both proximally and distally in 2 of them. The average distance from the joints was 6 cm in stems with flanches and 11.8 cm in stems without flanches. No aseptic loosening or deep infection was observed during an average follow-up of 34 months. Except for one case with a tibial intercalary prosthesis that needed a revision, all cases were well osteointegrated and all lower extremity cases could bear full weight without pain. In cases where the remaining bone stock after bone resection is insufficient for a standard stem implantation, reconstruction with a patient-specific short hollow-stem design appears to be a good alternative to protect healthy joints with high prosthesis survival and low revision rates in the short-term follow-up.
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http://dx.doi.org/10.3390/jpm14090919 | DOI Listing |
World J Surg Oncol
December 2024
Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.
Background: Endoprosthetic knee replacement using megaprostheses has become a common strategy for preserving joint function in patients with distal femur tumors. While existing literature has primarily focused on surgical techniques, complications, and implants, recent improvements in patient survival rates have sparked increased interest in the long-term functional outcomes associated with this treatment.
Methods: This case-control study evaluated functional outcomes-Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), knee flexor and extensor muscle strength, and sagittal knee range of motion-and health-related quality of life (SF-36) between patients with distal femoral megaprostheses (n = 31) and healthy controls (n = 48).
Bone Jt Open
December 2024
Glasgow Royal Infirmary, Glasgow, UK.
Aims: Limb salvage surgery (LSS) is the primary treatment option for primary bone malignancy. It involves the removal of bone and tissue, followed by reconstruction with endoprosthetic replacements (EPRs) to prevent amputation. Trabecular metal (TM) collars have been developed to encourage bone ingrowth (osseointegration (OI)) into EPRs.
View Article and Find Full Text PDFCurr Rev Musculoskelet Med
December 2024
Department of Orthopaedic Surgery, University of California San Francisco, 500 Parnassus Ave MU-320W, San Francisco, CA, 94143-0728, USA.
Purpose Of The Review: Anatomic and reverse endoprosthetic reconstruction are two common surgical options used after tumor resection of the proximal humerus. The purpose of this article is to provide an overview of the functional outcomes and complications of modern anatomic and reverse endoprostheses.
Recent Findings: The anatomic endoprosthesis has traditionally been a successful reconstructive technique as it provided a stable platform upon which the hand and elbow could function.
Curr Health Sci J
September 2024
Department of Orthopedics, University of Medicine and Pharmacy of Craiova, Romania.
Objective: The objective of this study was to establish a zone of clinical equipoise for the Proximal FEmur Resection or Internal Fixation fOR Metastases (PERFORM) randomized controlled trial, which will compare resection and endoprosthetic reconstruction to internal fixation for skeletal metastases of the proximal femur.
Methods: A survey was developed, piloted, and distributed to self-declared interested stakeholders in the PERFORM trial. The survey targeted orthopedic oncologists and was designed to assess patient and bone lesion characteristics that drive surgical decision-making in the treatment of skeletal metastases in the proximal femur.
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