High complication rate after extendible endoprosthetic replacement of the proximal tibia: a retrospective study of 42 consecutive children
DOI:
https://doi.org/10.1080/17453674.2018.1534320Abstract
Background and purpose — The long-term outcome of reconstruction with extendible prostheses after resection of tumors the proximal tibia in children is unknown. We investigated the functional outcome, complication rate and final limb salvage rate after this procedure. Patients and methods — 42 children who had a primary extendible replacement of the proximal tibia for bone tumor with a Stanmore implant between 1992 and 2013 were identified in the department’s database. All notes were reviewed to identify the oncological and functional outcomes, the incidence of complications and the rate of amputation. 20 children were alive at final follow-up. Median follow-up time was 6 years and minimum follow-up for surviving patients was 3 years. Results — The overall limb salvage rate was 35/42; amputation was needed in 7 children. 15 implants were revised with a new implant. The Musculoskeletal Tumor Society Score was 73% (40–93) at final follow-up. The overall complication rate was 32/42. Soft tissue problems were the most common mode of complication, noted in 15 children, whereas structural failure and infection occurred in 12 children each. Use of prostheses with non-invasive lengthening was associated with a higher infection rate as compared with conventional ones (4/6 vs. 8/36) and inferior limb survival. Interpretation — Extendible replacements of the proximal tibia allow for limb salvage and satisfactory late functional outcome but have a high rate of complications. The use of non-invasive lengthening implants has not shown any benefit compared with conventional designs and is, rather, associated with higher risk for infection and amputation.Downloads
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Published
2018-11-02
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Tsagozis, P., Parry, M., & Grimer, R. (2018). High complication rate after extendible endoprosthetic replacement of the proximal tibia: a retrospective study of 42 consecutive children. Acta Orthopaedica, 89(6), 678–682. https://doi.org/10.1080/17453674.2018.1534320
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Copyright (c) 2018 Panagiotis Tsagozis, Michael Parry, Robert Grimer
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Orthopaedica (Scandinavica) content is available freely online as from volume 1, 1930. The journal owner owns the copyright for all material published until volume 80, 2009. As of June 2009, the journal has however been published fully Open Access, meaning the authors retain copyright to their work. As of June 2009, articles have been published under CC-BY-NC or CC-BY licenses, unless otherwise specified.