Advances in tumour endoprostheses: a systematic review

Abstract

Tumour endoprostheses have facilitated limb-salvage procedures in primary bone and soft tissue sarcomas, and are increasingly being used in symptomatic metastases of the long bones. The objective of the present review was to analyse articles published over the last three years on tumour endoprostheses and to summarize current knowledge on this topic. The NCBI PubMed webpage was used to identify original articles published between January 2015 and April 2018 in journals with an impact factor in the top 25.9% of the respective category (orthopaedics, multidisciplinary sciences). The following search-terms were used: tumour endoprosthesis, advances tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND tumour. We identified 347 original articles, of which 53 complied with the abovementioned criteria. Articles were categorized into (1) tumour endoprostheses in the shoulder girdle, (2) tumour endoprostheses in the proximal femur, (3) tumour endoprostheses of the knee region, (4) tumour endoprostheses in the pelvis, (5) (expandable) prostheses in children and (6) long-term results of tumour endoprostheses. The topics of interest covered by the selected studies largely matched with the main research questions stated at a consensus meeting, with survival outcome of orthopaedic implants being the most commonly raised research question. As many studies reported on the risk of deep infections, research in the future should also focus on potential preventive methods in endoprosthetic tumour reconstruction. Cite this article: EFORT Open Rev 2019;4:445-459. DOI: 10.1302/2058-5241.4.180081

Clinical outcomes of frozen autograft reconstruction for the treatment of primary bone sarcoma in adolescents and young adults

“…Limb salvage surgery includes tumor excision and reconstruction with bone graft, synthetics, or an implant, and there are several reconstruction techniques. Reconstruction using a tumor prosthesis is commonly performed after excision of bone tumors in all generations 9 , 10 . However, this type of reconstruction has a limited durability and several reoperations will be necessary, especially for young patients.…”

Surgical treatment of skeletal metastases in proximal tibia: a multicenter case series of 74 patients

“…The literature describing the outcomes of proximal tibial pathological fractures is limited (Smolle et al 2019), but what is known is that treatment complications are common for tumors in this location (Mavrogenis et al 2013). The optimum method for reconstruction lacks consensus.…”

“…Reconstruction of the proximal tibia using a tumor endoprosthesis is associated with a high rate of complication and failure (Smolle et al. 2019 ). Our study demonstrates that this is also true for patients treated with tumor prosthesis for MBD in the proximal tibia.…”

What Opinions Do Tumor Reconstructive Surgeons Have about Sports Activity after Megaprosthetic Replacement in Hip and Knee? Results of the MoReSports Expert Opinion Online Survey

“…Megaprosthetic replacement is commonly performed in lower-limb reconstruction after tumor resections [ 16 , 17 , 18 , 19 ] as well as increasingly after trauma [ 20 , 21 , 22 ] or failed primary endoprosthetic replacement [ 23 , 24 ]. Despite their high rates of long-term sequelae including infection, mechanical and soft tissue failures, and loosening, patients benefit from surgery by being able to use their lower extremities in activities of daily living.…”