Knee function after limb salvage surgery for malignant bone tumor: comparison of megaprosthesis and distal femur allograft with epiphysis sparing

Pesenti, Sébastien; Peltier, Émilie; Pomero, Vincent; Authier, Guillaume; Roscigni, Lionel; Viehweger, Elke; Jouve, Jean-Luc

doi:10.1007/s00264-017-3608-x

Cited by 22 publications

(27 citation statements)

References 18 publications

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“…According to Pesenti et al, there was no difference in gait pattern between the groups, albeit in the megaprosthesis group, a decreased knee flexion during the load and stance phase was observed. 32 Moreover, the Gait Deviation Index (GDI), was significantly lower in both groups as compared to a control group. 32 Therefore, sparing of the epiphysis may not significantly increase the functional outcome in patients with tumours around the knee joint.…”

Section: Resultsmentioning

confidence: 87%

“…32 Moreover, the Gait Deviation Index (GDI), was significantly lower in both groups as compared to a control group. 32 Therefore, sparing of the epiphysis may not significantly increase the functional outcome in patients with tumours around the knee joint.…”

Section: Resultsmentioning

confidence: 87%

“…Another interesting study investigated the postoperative mobility in patients receiving allografts ( n = 15) or megaprostheses ( n = 6) for malignant tumours of the knee region. 32 An allograft augmented with a fibula graft was implanted in cases where more than 2 cm above the knee joint could be kept. According to Pesenti et al, there was no difference in gait pattern between the groups, albeit in the megaprosthesis group, a decreased knee flexion during the load and stance phase was observed.…”

Section: Resultsmentioning

confidence: 99%

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Advances in tumour endoprostheses: a systematic review

et al. 2019

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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

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

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Advances in tumour endoprostheses: a systematic review

et al. 2019

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“…These advancements in bone tumor management have given both surgeons and patients more options for treatment, other than mere limb ablation. Currently, 90–95% of patients with sarcoma of the extremities that were administered in tertiary referral centre can undergo musculoskeletal LSS with a successful result [[5], [6], [7], [8], [9]].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of various limb salvage surgeries in osteosarcoma around knee: Megaprosthesis, extracorporeal irradiation and resection arthrodesis

Kamal

Rubiansyah

2019

Annals of Medicine and Surgery

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Background We evaluated the outcome and the survival rate of Limb salvage surgeries (LSSs) in osteosarcoma around knee by using megaprosthesis, ECI autograft, and modified arthrodesis of the knee with metallic plus bone cement (MAMC). Methods We reviewed 35 cases of osteosarcoma around the knee that was treated by megaprosthesis, ECI autograft and MAMC from 2012 to 2017. The survival, local recurrence, metastases, complications and functional MSTS score were evaluated for each operation technique. Kaplan-Meier was used to describe the survival rate for each technique. Result Megaprostheses group had an excellent MSTS score (78.7%), the ECI group (72.3%) and MAMC group (68.4%). Local recurrence occurred in the megaprothesis group (0%), the ECI group (9.1%) and MAMC group (20%). Infection occurred in 3 cases of ECI (13.6%) while only 2 (40%) cases in MAMC group and 1 case (12.5%) in the megaprostheses group. Aseptic loosening occurred in the megaprostheses group 1 case (12.5%) and MAMC 1 case (20%). Metastases occurred in 18.2% of the ECI group compared to 25% of the megaprostheses group and 40% of the MAMC group. The megaprosthesis group had an overall survival rate of 90.9 months, whilst the ECI group is on 94.6 months and the MAMC group was 47.2 months. Conclusion Megaprosthesis showed good-excellent functional outcome and survival rate. ECI that is an option in LSS has good functional outcome as well. Knee arthrodesis with MAMC it is still an option to perform LSS even in the advanced local stage of the disease.

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“…Previous studies have found good knee range of motion and function after joint preservation [30,31], and to further explore the knee function status after JPLS, our study also added the IKDC score to evaluate the postoperative joint function and movement. The IKDC score provides a comprehensive evaluation of the subjective symptoms and objective signs of the knee system and applies to various knee conditions.…”

Section: Discussionmentioning

confidence: 99%

Comparative Observation of Two Types of Limb Salvage Surgery on Limb Function and Quality of Life in Patients With Knee Joint Osteosarcoma

Hou¹,

Bai²,

Xu³

et al. 2020

Preprint

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BackgroundWe compared the effects of two surgical procedures on limb function and quality of life in patients with osteosarcoma in the knee.MethodsThis retrospective study evaluated the postoperative outcomes of patients treated with JPLS and JPRS for osteosarcoma around the knee between November 2000 and December 2019. All patients were followed up for at least one year. Patients' lower extremity function, knee function, and quality of life were evaluated during follow-up using the MSTS score, IKDC score, and SF-36 score.ResultsAll 38 patients received a successful operation, and all incisions healed in one stage after surgery. At 12 months after the operation, the MSTS score in the prosthetic-replacement group (22.79±5.22) was lower than that in the joint-preservation group (27.05±1.62)(P=0.002). The IKDC score was lower in the prosthetic-replacement group (59.89±11.22) than in the joint-preservation group (76.84±9.42)( P <0.001). After 12 months, the SF-36 scores of physiological and social function in the joint-preserving group were higher than those in the prosthetic-replacement group (P <0.05), and there were no significant differences among the other indexes (P >0.05). Comparing the distribution of each item in the MSTS and IKDC scoring criteria between the joint-preservation and the prosthetic-replacement group revealed that the limb function, pain, satisfaction, support assistance, and the walking and gait of the joint preservation group were superior to those of the prosthetic-replacement group (P < 0.05). There was no significant difference in knee flexion between the two groups (P > 0.05). However, the joint preservation group was superior to the prosthesis replacement group in terms of pain, swelling, twisting, softening of the leg, movement downstairs, sitting up from a chair, kneeling, squatting, running straight forward, jumping up with the injured leg and landing, and quickly stopping or starting (P < 0.05).ConclusionCompared with joint-prosthesis replacement surgery, joint-preservation limb salvage leads to better joint function and quality of life. To improve the limb function and quality of life of patients with long-term survival osteosarcoma, joint-preservation limb salvage should be carried out according to the principles of Operation Indication, neoadjuvant and effective chemotherapy.

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Knee function after limb salvage surgery for malignant bone tumor: comparison of megaprosthesis and distal femur allograft with epiphysis sparing

Abstract: 4.

Cited by 22 publications

References 18 publications

Advances in tumour endoprostheses: a systematic review

Advances in tumour endoprostheses: a systematic review

Clinical outcome of various limb salvage surgeries in osteosarcoma around knee: Megaprosthesis, extracorporeal irradiation and resection arthrodesis

Comparative Observation of Two Types of Limb Salvage Surgery on Limb Function and Quality of Life in Patients With Knee Joint Osteosarcoma

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