Infective complications following tumour endoprosthesis surgery for bone and soft tissue tumours

Peel, Trisha; May, Deborah C.; Buising, Kirsty; Thursky, Karin; Slavin, Monica A; Choong, Peter F. M.

doi:10.1016/j.ejso.2014.02.241

Cited by 45 publications

(73 citation statements)

References 23 publications

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“…Complications are found to be over‐represented in this group of patients compared to what is seen in regular joint replacement surgery. Especially the number of infections varying from 2% to 16% in previous studies is high, and one study found infection risk near 40% . In our study, 11 of 119 (9%) patients experienced a deep infection, all of them after the primary surgical procedure, and six underwent additional surgery due to infection.…”

Section: Discussioncontrasting

confidence: 41%

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Long‐term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb‐sparing bone resections in orthopedic oncologic conditions: Results from a national cohort

Yilmaz

Sørensen

Saebye

et al. 2019

Journal of Surgical Oncology

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Background and Objectives We investigated implant revision, implant failure, and amputation risk after limb‐sparing bone tumor surgery using the Global Modular Replacement System (GMRS) tumor prosthesis in patients suffering from bone sarcomas (BS), giant cell tumors (GCT), or metastatic bone disease (MBD). Material and Methods A retrospective study of a nationwide consecutive cohort (n = 119, 47 [12‐81] years, M/F = 65/54) having limb‐sparing surgery and reconstruction using the GMRS tumor prosthesis due to bone tumors (BS/GCT/MBD = 70/8/41) from 2005 to 2013. Anatomical locations were as followed: distal femur (n = 49), proximal femur (n = 41), proximal tibia (n = 26), or total femur (n = 3). Kaplan‐Meier survival analysis and competing risk analysis with death as a competing risk were used for statistical analysis. Results For BS and GCT patients, 5‐year patient survival was 72% (95% confidence interval [CI]: 59‐85%) and for MBD 33% (95% CI: 19‐48%). Thirty‐two patients underwent revision surgery (5‐year revision incidence 14%; 95% CI: 8‐21%). Twelve patients had revision of bone‐anchored parts (implant failure) with a 5‐year revision incidence 6% (95% CI: 2‐10%). Ten amputations were performed due to local relapse (n = 9) or recurrent infections (n = 1) with a 5‐year incidence of amputation: 8% (95% CI: 3‐13%). Conclusions We identified a low risk of revision and amputation when using the GMRS tumor prosthesis for limb‐sparing bone tumor.

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Section: Discussioncontrasting

confidence: 41%

“…Especially the number of infections varying from 2% to 16% in previous studies 3,7,10,11,[18][19][20][21] is high, and one study found infection risk near 40%. 3 In our study, 11 of 119 (9%) patients experienced a deep infection, all of them after the primary surgical procedure, and six underwent additional surgery due to infection.…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb‐sparing bone resections in orthopedic oncologic conditions: Results from a national cohort

Yilmaz

Sørensen

Saebye

et al. 2019

Journal of Surgical Oncology

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“…Operative time, blood loss and wound complications are risk factors for infection [36]. Despite conformation to asepsis, infection was found in 3 patients, as described above, probably due to immune suppression by chemotherapy and soft-tissue defects.…”

Section: Discussionmentioning

confidence: 99%

“…Revision was not carried out until normal levels of blood infection markers were obtained. Of note, debridement and retention for management of early and late acute infections have significant success rates [36], likely providing an approach to resist microbial infection. Meanwhile, we found that infection incidence was plummeting among patients with medial gastrocnemius flap transposition.…”

Section: Discussionmentioning

confidence: 99%

The multidisciplinary treatment of osteosarcoma of the proximal tibia: a retrospective study

Huang

Han

et al. 2018

BMC Musculoskelet Disord

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BackgroundSurvival and reconstruction constitute important challenges in multimodal treatment of osteosarcoma of the proximal tibia. The purpose of this study was to assess the efficacy and prognosis of neoadjuvant chemotherapy and custom-designed endoprosthetic arthroplasty.MethodsA total of 69 patients with osteosarcoma of the proximal tibia were evaluated, including 43 males and 26 females, treated with multidisciplinary limb-salvage remedy from October 2003 to December 2013. They were at least 12 years old (mean, 20 years; range, 12–57 years). The gap between tumor and main artery/nerve was showed in MRI. Mean follow up was 69.5 months (range, 9–144 months). Kaplan-Meier survival curves were generated to assess prognosis and relapse rate. The initial symptoms and disease duration for each patient were recorded. Correlation analyses were performed for the association of various parameters with prognosis. Functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS) guidelines after 6 months postoperatively, to analyze the relation between bone excision size and function recovery.ResultsThe resection lengths measured intraoperatively ranged from 80 to 230 mm, and contained 3 cm of normal bone around the tumor. A total of 3 courses of preoperative chemotherapy were administered to all cases. At final follow-up, 1 case showed recurrence. Meanwhile, 8 patients (11.6%) died from lung metastasis. Post-operative infection occurred in 3 patients; 1 case was maintained with revision surgery. Two cases underwent amputation. The mean MSTS system score was 21.6.ConclusionsThe multidisciplinary treatment result in an overall positive outcome, with improved function.

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“…It is especially troublesome that there are no differences between an implant that is used for an elderly patient who breaks their osteoporotic femur and a young adult with bone cancer, yet the cause for bone fractures among the two are completely different and should require unique, tailored implants. Along with implant loosening, fracture and wear, infection is a common mode of failure for any orthopedic implant causing undue pain often requiring reoperation . Additionally, with the rise of antibiotic‐resistant bacteria strains, and especially their prevalence in hospital settings, it is increasingly important to prevent these infections from occurring .…”

Section: Introductionmentioning

confidence: 99%

Reducing bone cancer cell functions using selenium nanocomposites

Stolzoff

Webster

2015

J Biomedical Materials Res

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Cancer recurrence at the site of tumor resection remains a major threat to patient survival despite modern cancer therapeutic advances. Osteosarcoma, in particular, is a very aggressive primary bone cancer that commonly recurs after surgical resection, radiation, and chemotherapeutic treatment. The objective of the present in vitro study was to develop a material that could decrease bone cancer cell recurrence while promoting healthy bone cell functions. Selenium is a natural part of our diet which has shown promise for reducing cancer cell functions, inhibiting bacteria, and promoting healthy cells functions, yet, it has not been widely explored for osteosarcoma applications. For this purpose, due to their increased surface area, selenium nanoparticles (SeNP) were precipitated on a very common orthopedic tissue engineering material, poly-l-lactic acid (or PLLA). Selenium-coated PLLA materials were shown to selectively decrease long-term osteosarcoma cell density while promoting healthy, noncancerous, osteoblast functions (for example, up to two times more alkaline phosphatase activity on selenium coated compared to osteoblasts grown on typical tissue culture plates), suggesting they should be further studied for replacing tumorous bone tissue with healthy bone tissue. Importantly, results of this study were achieved without the use of chemotherapeutics or pharmaceutical agents, which have negative side effects.

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Infective complications following tumour endoprosthesis surgery for bone and soft tissue tumours

Cited by 45 publications

References 23 publications

Long‐term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb‐sparing bone resections in orthopedic oncologic conditions: Results from a national cohort

Long‐term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb‐sparing bone resections in orthopedic oncologic conditions: Results from a national cohort

The multidisciplinary treatment of osteosarcoma of the proximal tibia: a retrospective study

Reducing bone cancer cell functions using selenium nanocomposites

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