Application and Development of Megaprostheses in Limb Salvage for Bone Tumors Around the Knee Joint

Zhang, Hao-Ran

doi:10.1177/10732748221099219

Cited by 8 publications

(9 citation statements)

References 51 publications

(128 reference statements)

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“…None of them had pre-operative pathological fractures. On average, their pre-operative MSTS score was 10.4 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, having standardized implant components and common toolkits increased the level of standardization and reproducibility for these surgical procedures, increasing the experience and the confidence of the most experienced orthopedic oncologists. For all these reasons, modular megaprostheses are still the most used reconstructive approaches for reconstruing the distal femur after bone tumor resections [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol

Andreani,

Ipponi,

Falcinelli

et al. 2023

Healthcare

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Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment is yet to be established. In this study, we report on our experience with our latest standardized rehabilitation program, evaluating our results in a mid-to-long-term scenario. Materials and Methods: We evaluated the functional results of all our oncologic patients treated between 2016 and 2022 who could follow our standardized post-operative rehabilitative approach, consisting of progressive knee mobilization and early weight-bearing. Results: Sixteen cases were included in our study. The average duration of the patients’ hospitalization was 12.2 days. A standing position was reached on average 4.1 days after surgery, while assisted walking was started 4.5 days after surgery. After a mean post-operative follow-up of 46.7 months, our patients’ mean MSTS score was 23.2 (10–30). Our data suggest that the sooner patients could achieve a standing position (R = −0.609; p = 0.012) and start walking (R = −0.623; p = 0.010), the better their final functional outcomes regarding their MSTS scores. Conclusions: Rehabilitation should be considered a pivotal factor in decreeing the success of distal femur megaprosthetic implants in long-surviving oncologic patients. Correct rehabilitation, focused on early mobilization and progressive weight-bearing, is crucial to maximizing the post-operative functional outcomes of these patients.

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“…None of them had pre-operative pathological fractures. On average, their pre-operative MSTS score was 10.4 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol

Andreani,

Ipponi,

Falcinelli

et al. 2023

Healthcare

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“…Limited remaining bone after resection is a risk factor for inadequate fixation and subsequent implant loosening. Aseptic loosening is a major cause of the failure of megaprostheses [ 7 ], and the novel stem used here may overcome some of the limitations of traditional fixation methods.…”

Section: Discussionmentioning

confidence: 99%

Malignant Transformation in Ollier's Disease: A Novel Stem for a Tibial Megaprosthesis

Ng¹,

Khoury²

2023

Cureus

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Ollier's disease is a rare syndrome characterized by multiple enchondromas with the potential for malignant transformation. The treatment for secondary chondrosarcoma is surgical resection, which can be a morbid procedure depending on the location and size of the tumor. We present a successful limb salvage in which the majority of the tibia was removed and replaced with a megaprosthesis. The complex reconstruction in this case required the use of a novel uncemented stem.

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“…The modularity of MUTARS makes it versatile for the reconstruction of different skeletal segments, meeting the biomechanical requirements of the single surgical case. Compared with other reconstruction methods, MUTARS have some advantages: relatively simple, early weight bearing, fewer early complications, and a lower rate of mechanical failures [ 11 ]. Moreover, the functional outcome after reconstruction with megaprostheses is often very satisfying, and patients can enjoy a good quality of life [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Functional and Rehabilitative Outcomes of Patients Affected by Bone Cancer of the Upper Limb Treated with MUTARS Prosthesis: A Narrative Review

Codazza,

Ferrara,

Aprovitola

et al. 2024

JCM

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Megaprostheses are well-known, reliable, and effective reconstruction prostheses used in oncologic surgery for limb salvage in patients affected by primary or metastatic bone tumors.Rehabilitation plays a major role after MUTARS replacement, with the aim of improving function after surgery and maintaining the highest possible quality of life. Only a few studies have been published about the use of megaprostheses for the upper limb. The aim of this narrative review is to describe the results of functional and rehabilitative outcomes of patients affected by bone primary or metastatic bone cancer of the upper limb and surgically treated with MUTARS prostheses. A comprehensive search was conducted on PubMed and Scopus using the following MESH terms: “Mutars”, “Megaprosthesis”, “bone”, “tumors”, “metastasis”, “upper limb”, “rehabilitation”, “outcome”, “quality of life”, and 10 studies were included. The most frequent oncological pathology was found to be metastases of the proximal humerus treated with modular endoprosthesis or modular reverse implants. Outcome measures used were ROM, MSTS, ASES, DASH, Constant-Murley score, Enneking score, VAS, MEP, TESS, and WOSI. Reconstruction of the proximal humerus with the MUTARS system seemed to be a valid treatment option after bone tumor resection. Rehabilitation after MUTARS surgery is very relevant, but currently, functional and rehabilitative outcomes are inadequately represented in the literature. Hence, further studies are needed to define standardized rehabilitation protocols after oncological orthopedic surgery that can be applied routinely in clinical practice.

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Application and Development of Megaprostheses in Limb Salvage for Bone Tumors Around the Knee Joint

Cited by 8 publications

References 51 publications

Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol

Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol

Malignant Transformation in Ollier's Disease: A Novel Stem for a Tibial Megaprosthesis

Functional and Rehabilitative Outcomes of Patients Affected by Bone Cancer of the Upper Limb Treated with MUTARS Prosthesis: A Narrative Review

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