Endoprosthetic Replacement for Primary Malignant Tumors of the Proximal Femur

Kabukçuoğlu, Yavuz; Grimer, R. J.; Tillman, R. M.; Carter, Simon R.

doi:10.1097/00003086-199901000-00003

Cited by 107 publications

(103 citation statements)

References 14 publications

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“…These results are comparable to those in other studies [4,11,13,14,22,31,42]. In series ranging from 16 to 27 patients, the allograft-prosthesis composite survival rates ranged from 76% to 100% at 5 years and 76% to 86% at 10 years [11,13,42].…”

Section: Discussionsupporting

confidence: 88%

“…In series ranging from 16 to 27 patients, the allograft-prosthesis composite survival rates ranged from 76% to 100% at 5 years and 76% to 86% at 10 years [11,13,42]. In series ranging from 17 to 96 patients, the megaprosthesis survival rates ranged from 65% to 86% at 5 years and from 0% to 86% at 10 years [4,13,14,22,31,42]. To date, however, comparative studies of allograftprosthesis composites versus megaprostheses have failed to show improved longevity of the former [4,13,42] (Table 4).…”

Section: Discussionmentioning

confidence: 99%

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Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

Biau

Larousserie

Thévenin

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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The use of allograft-prosthesis composites for reconstruction after bone tumor resection at the proximal femur has generated considerable interest since the mid1980s on the basis that their use would improve function and survival, and restore bone stock. Although functional improvement has been documented, it is unknown whether these composites survive long periods and whether they restore bone stock. We therefore determined long-term allograft-prosthesis composite survival, identified major complications that led to revision, and determined whether allograft bone stock could be spared at the time of revision. We also compared the radiographic appearance of allografts sterilized by gamma radiation and fresh-frozen allografts. We retrospectively reviewed 32 patients with bone malignancy in the proximal femur who underwent reconstruction with a cemented allograft-prosthesis composite. The allograft-prosthesis composite was a primary reconstruction for 23 patients and a revision procedure for nine. The minimum followup was 2 months (median, 68 months; range, 2-232 months). The cumulative incidence of revision for any reason was 14% at 5 years (95% confidence interval, 1%-28%) and 19% at 10 years (95% confidence interval, 3%-34%). Nine patients (28%) had revision of the reconstruction during followup; four of these patients had revision surgery for infection. Allografts sterilized by gamma radiation showed worse resorption than fresh-frozen allografts. Based on reported results, allograft-composite prostheses do not appear to improve survival compared with megaprostheses.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

Biau

Larousserie

Thévenin

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Therefore, a wide excision is considered mandatory to achieve the complete removal of a tumor (1,19,20). However, a wide excision often necessitates removal of functional structures, resulting in prolonged surgery time and compromised limb function (3,8,(20)(21)(22). Furthermore, recurrences and metastases are not rare in patients undergoing a wide excision of a tumor (1,19).…”

Section: Discussionmentioning

confidence: 99%

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

Chen

et al. 2017

Oncology Letters

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Abstract.A wide resection of the tumor with or without chemotherapy is the treatment of choice for periosteal osteosarcoma (PO) of the extremities, however, post-operative limb function and quality of life could be compromised. The present study reports two cases of 14-year-old boys who presented with progressively enlarging masses in their right knee regions. Computed tomography and magnetic resonance imaging scans indicated a fusiform space-occupying mass encircling the bone cortex, with stippled calcification. A diagnosis of PO was suspected. The histological findings confirmed the diagnosis of intermediate PO. Pre-operative chemotherapies were started, and good responses were detected by clinical evaluation and histological findings. Surgeries preserving the functional structures, including neurovascular bundles, tendons, muscles and epiphyses, were performed, followed by routine chemotherapy. The two patients experienced disease-free survival with follow-up times of 37 and 108 months, respectively. The patients were satisfied with the results of the treatment and they returned to normal life activities. These two cases indicated that a marginal resection of the tumor in conjunction with effective neoadjuvant chemotherapy may be an ideal alternative treatment for intermediate PO, since survival along with well-preserved limb function could be guaranteed. By contrast, a wide excision could result in the loss of limb function.

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“…Tumor endoprosthetic survival rates are mostly about 60 % to 80 % at 5 years, and 40-70 % at 10 years. [21][22][23] For the current rotating-hinge knee design, reported follow-up is limited to approximately 10 years. Malawer et al [24] in 1995 showed an 83 % survival of prostheses at 5 years and 67 % at 10 years.…”

Section: Discussionmentioning

confidence: 99%

Limb Salvage Surgery in Bone Tumors: A Retrospective Study of 50 Cases in a Single Center

Chauhan

Joshi

Chopra³

et al. 2013

Indian J Surg Oncol

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Modular segmental replacement system (MSRS) is one of the options for Limb conservation surgery in bone tumors. The study analyses a single center experience of use of MSRS for limb conservation in cases of primary bone tumors. Retrospective analysis was done for a series of cases of limb salvage procedures done over a five year period. All Patients with bone tumors who underwent limb salvage procedures utilising MSRS prosthesis were included in the study. The patients' record were perused for pre operative staging; neoadjuvant therapy used, if any; surgical procedure done; follow-up for prosthesis related complications and overall survival achieved. Total of 50 cases studied,included 28 males and 22 females . Median age at diagnosis of 28 (10-73) years. Tumor localized in lower limb in 38 patients, and upper limb in 12 patients. Tumors were malignant in 28 patients (56 %) and benign in 22 (44 %). The most common diagnosis was osteosarcoma (21 patients (42 %)) . The median resection length was 15 cm (range 6-25). High grade tumors (grade 2a and 2b) was found in 27 of 29 cases(93.1 %) . 14 patients had prosthesis related complications. The mean follow-up was 5 years (range: 3-7). 42 patients of 50 were alive with the endoprosthesis at the last follow-up. Survival rate of prosthesis is 84 %. The modular segmental-replacement system prosthesis favoured by us in limb sparing surgery for bone tumors results in satisfactory results in terms of tumor control and limb function.

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Endoprosthetic Replacement for Primary Malignant Tumors of the Proximal Femur

Cited by 107 publications

References 14 publications

Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

Limb Salvage Surgery in Bone Tumors: A Retrospective Study of 50 Cases in a Single Center

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