Article
Cementless dia-metaphyseal conical anchorage of tumor-endoprostheses for limb-salvage in patients with large osseous resections of the femur & tibia
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Published: | June 13, 2005 |
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Outline
Text
In cases of large resection with involvement of more then half of the length of the femur or tibia cementless fixation of megaprostheses may be a problem. It was the aim of this study to evaluate the results after reconstruction of long bones with a special conical and/or metaphyseal anchorage.
Methods
Patients were reexamined with the functional Enneking-score procedures and the Karnofsky-Score.
Results
From 1997-2003 22 patients were treated with limb-salvage by implantation of a megaprostheses with an conical fixation and metaphyseal anchorage. The age was 39.6 yrs (17-64); 11 were female, 12 were male. The location was 14x dist. femur, 5x prox. femur, 4x prox. tibia. The diagnosis was 5x chondrosarcoma, 8x osteosarcoma, 3x MFH, undifferentiated sarcoma, Ewing's sarcoma, synovial sarcoma, metastasis, radiation sarcoma, femoral dysplasia, echinococceal ostemomyelitis each 1x; the reason for implantation was primary implantation 16x ; aseptic loosening megaprosthesis 4x; breakage of a megaprosthesis, low-grade infection and synovial sarcoma each 1x. The length of replacement was 22cm (12-32).
At follow-up 19 pat. were NED, 1X AWD, 1X DOD; in one pat. the megaprosthesis had to be removed and one had to be amputated both due to infection. The megaprostheses stayed in place in 19 pat.; Complications: 2x quadriceps rupture, 1x deep venous thrombosis. In 3 pat. the prosthesis had to be removed because of infection or because of tumor progress; in 15/19 pat. follow-up was possible (follow-up-period: 18.5 mo (12-32) postop.). The Enneking-functional score was 23 (12-29), the Karnofsky-score was 83% (60-100%).
Conclusions
Implantation of such special megaprostheses with a large length of replacement exhibited acceptable follow-up results with an also acceptable rate of complications regarding the extend of the procedure.