Intermediate-term results and risk factors analysis of tumor endoprosthesis in paediatric patients after the resection of lower extremity bone sarcoma
| Autor: | Man Lung Moses Li, Kwok Chuen Wong, Wang Kei Chiu, Shekhar-madhukar Kumta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Journal of Orthopaedic Surgery, Vol 30 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2309-4990 10225536 |
| DOI: | 10.1177/10225536221132403 |
| Popis: | Background Mechanical failure of the endoprostheses is a concern in paediatric patients with primary bone sarcoma. Their long-term results are variable in the Asian population, thus we aim to investigate the outcome by assessing the mechanical failure, its risk factors and the functional results. Methods We retrospectively reviewed 38 paediatric patients (mean 13.29, range 6–18) with primary bone sarcoma of lower extremity undergone chemotherapy and limb salvage surgery with tumor endoprosthesis between 2003 and 2016. All hospital notes were reviewed for any type of failures. Risk factors for implant loosening like stem size, remaining bone length, stem length, extracortical bone bridge ingrowth (EBBI), the ratio of resected bone length to whole bone length, bone stem ratio and custom-made versus modular were analyzed. The limb function was recorded by Musculoskeletal Tumor Society (MSTS) score. Median follow-up time was 7.42 years (3.0–15.4 years) and minimum follow-up for surviving patients was 2 years. Results Endoprosthesis survivorship, according to Kaplan Meier was 94.7%, 85.4% and 66.2% at 2, 5 and 10 years respectively. Type II failure occurred in three patients (7.9%). Type III failure occurred in four patients (10.5%). Type IV failure occured in two patients (5.2%). Only EBBI independently predicted implant loosening ( p = .007). Risk factors like stem size, remaining bone length, stem length, the ratio of resected bone length to whole bone length and custom-made versus modular were not associated with increase in implant loosening ( p > .05). The mean stem size was 9.41 mm in asymptomatic group, comparable with 9.22 mm in the failure group ( p = .79). The MSTS score was 29.62. Conclusions Our data suggests that paediatric Chinese patients with small body built had good and excellent mid-term results in implant survival and limb function respectively. EBBI is important in preventing loosening in tumor endoprosthesis. In contrast to the reported higher failure risk with stem size |
| Databáze: | Directory of Open Access Journals |
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