Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study.

Rougraff, Bruce T.; Simon, Michael A.; Kneisl, Jeffrey S.; Greenberg, D. D.; Mankin, Henry J.

doi:10.2106/00004623-199405000-00004

Cited by 482 publications

(322 citation statements)

References 22 publications

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“…The orthopaedic literature describes multiple surgical options for reconstruction after resection of a bone tumor of the distal femur, including custom total knee prosthesis [2, 3, 6-16, 19, 27, 33], osteoarticular allograft [1,20,[25][26][27]30], arthrodesis with intercalary bone grafting [9,32], rotationplasty [10], and ''condyle-sparing'' intercalary allograft [23,24]. Controversy remains concerning the optimal procedure with regard to functional outcome.…”

Section: Introductionmentioning

confidence: 99%

“…Although a few studies compare amputation, rotationplasty, and arthrodesis with endoprosthetic reconstruction [9,10,25,26,29], even fewer compare endoprostheses with intercalary allografts, one in an animal model and the other for tumors in the proximal tibia [4,17]. These few studies about the condyle-sparing or epiphyseal preservation technique have been case reports or series with less than 20 patients [4,23] but raise concerns regarding the adequacy of surgical margins and the risk of local recurrence when preserving the distal femoral condyle [23].…”

Section: Introductionmentioning

confidence: 99%

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Megaprosthesis versus Condyle-sparing Intercalary Allograft: Distal Femoral Sarcoma

Zimel¹,

Cizik

Rapp³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Although functionally appealing in preserving the native knee, the condyle-sparing intercalary allograft of the distal femur may be associated with a higher risk of tumor recurrence and endoprosthetic replacement for malignant distal femoral bone tumors. We therefore compared the risk of local tumor recurrence between patients in these two types of reconstruction groups. We retrospectively reviewed 85 patients (mean age, 22 years; range, 4-82 years), 38 (45%) of whom had a condyle-sparing allograft and 47 (55%) of whom had endoprostheses. The minimum followup for both groups was 2 years (mean, 7 years; range, 2-19 years). Local recurrences occurred in 11% (five of 47) of the patients having implants versus 18% (seven of 38) of the patients having allografts. Using time to local recurrence as an end point, the Kaplan-Meier

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Megaprosthesis versus Condyle-sparing Intercalary Allograft: Distal Femoral Sarcoma

Zimel¹,

Cizik

Rapp³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Neoadjuvant and adjuvant treatment of bone sarcomas have allowed successful limb preservation surgery in pediatric patients [30,34]. Median Musculoskeletal Tumor Society (MSTS) functional scores of 80 have been reported in this population [1,13].…”

Section: Introductionmentioning

confidence: 99%

What are Estimated Reimbursements for Lower Extremity Prostheses Capable of Surgical and Nonsurgical Lengthening?

Henderson

Pepper

Letson

2012

Clinical Orthopaedics &Amp; Related Research

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Background Growing prostheses accommodate skeletally immature patients with bone tumors undergoing limbpreserving surgery. Early devices required surgical procedures for lengthening; recent devices lengthen without surgery. Expenses for newer expandable devices that lengthen without surgery are more than for their predecessors but overall reimbursement amounts are not known.Questions/purposes We sought to determine reimbursement amounts associated with lengthening of growing prostheses requiring surgical and nonsurgical lengthening. Methods We retrospectively reviewed 17 patients with growing prostheses requiring surgical expansion and eight patients with prostheses capable of nonsurgical expansion. Insurance documents were reviewed to determine the reimbursement for implantation, lengthening, and complications. Growth data were obtained from the literature. Results Mean reimbursement amounts of surgical and nonsurgical lengthenings were $9950 and $272, respectively. Estimated reimbursements associated with implantation of a growing prosthesis varied depending on age, sex, and location. The largest difference was found for 4-year-old boys with distal femoral replacement where reimbursement for expansion to maturity for surgical and nonsurgical lengthening prostheses would be $379,000 and $208,000, respectively. For children requiring more than one surgical expansion, net reimbursements were lower when a noninvasive lengthening device was used. Annual per-prosthesis maintenance reimbursements to address complications for surgical and nonsurgical lengthening prostheses were $3386 and $1856, respectively.

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“…Several reconstruction approaches are employed to provide a functional and durable extremity. Although initial studies confirm that limb-salvage surgery carries no greater risk of local recurrence or mortality compared with amputation [6], complications are common, and concerns about late revisions in this patient population remain [4]. Skeletal reconstruction with prosthetic components, large-allograft bone segments, autograft techniques, free fibula transfers, and novel autograft procedures (such as the ''turn-downplasty'' knee arthrodesis [9]) all have had some success.…”

mentioning

confidence: 99%

CORR Insights®: Is the Induced-membrane Technique Successful for Limb Reconstruction After Resecting Large Bone Tumors in Children?

Nicholas

2015

Clinical Orthopaedics &Amp; Related Research

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Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study.

Cited by 482 publications

References 22 publications

Megaprosthesis versus Condyle-sparing Intercalary Allograft: Distal Femoral Sarcoma

Megaprosthesis versus Condyle-sparing Intercalary Allograft: Distal Femoral Sarcoma

What are Estimated Reimbursements for Lower Extremity Prostheses Capable of Surgical and Nonsurgical Lengthening?

CORR Insights®: Is the Induced-membrane Technique Successful for Limb Reconstruction After Resecting Large Bone Tumors in Children?

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