Tumour endoprosthesis replacement in the proximal tibia after intra-articular knee resection in patients with sarcoma and recurrent giant cell tumour
| Autor: | Eike Bormann, Arne Streitbürger, Wiebke Guder, Markus Nottrott, Gregor Hauschild, Georg Gosheger, Dimosthenis Andreou, Maria Eveslage, Marcel-Philipp Henrichs, Jendrik Hardes |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Adolescent Knee Joint medicine.medical_treatment Periprosthetic Bone Neoplasms Kaplan-Meier Estimate Resection Proximal tibia Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Humans Medicine Orthopedic Procedures Orthopedics and Sports Medicine Cumulative incidence Child Aged Retrospective Studies 030222 orthopedics Tibia business.industry Giant Cell Tumors Sarcoma Middle Aged Limb Salvage medicine.disease Prosthesis Failure Surgery Treatment Outcome Amputation Giant cell 030220 oncology & carcinogenesis Orthopedic surgery Female Knee Prosthesis business |
| Zdroj: | International Orthopaedics. 42:2475-2481 |
| ISSN: | 1432-5195 0341-2695 |
| Popis: | Proximal tibia replacements are commonly associated with post-operative complications and poor functional results due to an insufficiency of the extensor mechanism. This study evaluated the clinical results with a special emphasis of the extensor mechanism reconstruction with a reattachment tube and complications after intra-articular resection of the proximal tibia and reconstruction with a tumour endoprosthesis (MUTARS®) in 98 patients (median age 18 years) with malignant bone tumours or giant cell tumours. Kaplan–Meier analysis showed that the limb survival rates were 94.9, 90.5 and 74.5% at one, two and ten years, respectively. Periprosthetic infection was the most common reason for secondary amputation (eight patients). The cumulative incidence rates of prosthetic failure (Henderson II–IV) were 18% at two years and 29% at five years post-operatively. An active extension deficit of more than 10° was noted in six patients only. These results suggest that limb salvage with tumour prostheses after intra-articular resection can achieve good functional results with an active extension of the knee in the majority of patients. While mechanical complications can be treated successfully with revision surgery, periprosthetic infection continues to be the main reason for secondary amputation. |
| Databáze: | OpenAIRE |
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