Artikel
Could a modular uncemented hollow stem that can be designed according to the remaining bone stock be a good opportunity to protect the adjacent joint?
Suche in Medline nach
Autoren
-
Recep Öztürk
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
-
Arne Streitbürger
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
-
Jendrik Hardes
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
-
Wiebke Guder
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
-
Lars E. Podleska
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
-
Markus Nottrott
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
-
Nina Myline Engel
- Klinik für Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen, Germany
| Veröffentlicht: | 21. Oktober 2024 |
|---|
Gliederung
Text
Objectives: If the remaining bone stock after bone resection in malignant tumors is insufficient for the implantation of conventional prosthetic bodies, the adjacent joint is usually sacrificed. This may lead to possible increased instability, permanent impairment of function, and increased wear of joint prosthesis components. This study aimed to analyze the follow-up results of megaprosthesis cases in which the adjacent joint was preserved using a custom-made short stem design.
Methods: In this study, a total of 13 patients, with an average age of 9.6 years, who underwent endoprosthetic reconstruction with a custom-made unsemented, modular hollow stem component between 2017 and 2023, were retrospectively analyzed in terms of reconstruction survival, and complications. The most common diagnosis was Ewing's sarcoma (n=7), and the most common reconstruction was proximal femoral tumor prosthesis (n=6).
Results and conclusion: The hollow body was used distally in 10 of the megaprotheses, proximally in 1, and both proximally and distally in 2 of them. In 2 cases, a buxtehuder stem was used in the proximal femur and 7 of the prostheses were expandable. Three of the cases were revision operations, and average surgery duration was 205 minutes. The average bone resection was 26 cm. Two patients died within an average of 22 months. One patient underwent hip revision due to chronic joint subluxation. A patient underwent temporary hemiepiepiphysiodesis due to genu valgum. The prosthesis of all patients who were followed up for an average of 34 months was preserved without any aseptic loosening or infection. However, tibial bowing and tilt along with partial consolidation were observed in 1 patient who underwent intercalary tibia prosthesis, and revision was planned when growth was completed. Eleven of 12 lower extremity cases could bear full weight without pain.
In cases where the remaining bone stock after bone resection is insufficient, reconstruction with a patient-specific short hollow stem design appears to be a good alternative with high prosthesis survival and low revision rates in the short term follow-up. Preservation of the adjacent joint may improve functional outcomes. As a result, this procedure may postpone or prevent resection of the adjacent joint.
Figure 1 [Fig. 1]
Table 1 [Tab. 1]
