Massive Prostheses for Malignant Bone Tumours of the Limbs

Cannon, Stephen R.

doi:10.1302/0301-620x.79b3.0790497

Cited by 32 publications

(16 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Devices to clamp soft tissues have been used in some prostheses. 2 In massive prostheses, non-absorbable sutures and slings have been used as the primary attachment mechanism. 1,4,5,8,9 Spiked devices for mechanical fixation have been studied experimentally and used clinically.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] The proximal tibia has certain anatomical limitations to its reconstruction. In particular there is a need for an effective method for reattachment of the patellar tendon.…”

mentioning

confidence: 99%

“…In particular there is a need for an effective method for reattachment of the patellar tendon. 2 Altered biomechanics because of failure of the extensor mechanism can result in patella alta, atrophy of the quadriceps and altered gait with an extensor lag. 2,3 Contemporary methods for reattachment of the patellar tendon produce an impaired functional outcome.…”

mentioning

confidence: 99%

“…2 Altered biomechanics because of failure of the extensor mechanism can result in patella alta, atrophy of the quadriceps and altered gait with an extensor lag. 2,3 Contemporary methods for reattachment of the patellar tendon produce an impaired functional outcome. 4,5 Assessment of function in clinical practice is commonly based on the scoring system of the Musculoskeletal Tumour Society, which assigns numerical values for the six categories of pain, function, emotional acceptance, supports, walking and gait.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Extensor mechanism reconstruction after proximal tibial replacement

Oddy

Pendegrass

Goodship

et al. 2005

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

We developed an in vivo model of the attachment of a patellar tendon to a metal implant to simulate the reconstruction of an extensor mechanism after replacement of the proximal tibia. In 24 ewes, the patellar tendon was attached to a hydroxyapatite (HA)-coated titanium prosthesis. In 12, the interface was augmented with autograft containing cancellous bone and marrow. In the remaining ewes, the interface was not grafted. Kinematic gait analysis showed nearly normal function of the joint by 12 weeks. Force-plate assessment showed a significant increase in functional weight-bearing in the grafted animals (p = 0.043). The tendon-implant interface showed that without graft, encapsulation of fibrous tissue occurred. With autograft, a developing tendon-bone-HA-implant interface was observed at six weeks and by 12 weeks a layered tendon-fibrocartilage-bone interface was seen which was similar to a direct-type enthesis. With stable mechanical fixation, an appropriate bioactive surface and biological augmentation the development of a functional tendon-implant interface can be achieved.

show abstract

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] The proximal tibia has certain anatomical limitations to its reconstruction. In particular there is a need for an effective method for reattachment of the patellar tendon.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Extensor mechanism reconstruction after proximal tibial replacement

Oddy

Pendegrass

Goodship

et al. 2005

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

show abstract

“…[6][7][8] When choosing which technique to use we should consider the long-term oncological and functional results, the expected survival age of the patient and the early and late complications of the type of reconstruction chosen. 9 Distraction osteogenesis (callus distraction) provides a biological method of reconstruction of the bone defect after resection of a tumour and is particularly useful for malignant tumours in young patients with a good long-term prognosis. 10,11 Vascularised fibular grafts are associated with rapid incorporation and union, and a low rate of infection, fracture, resorption and nonunion compared with non-vascularised grafts or allografts.…”

mentioning

confidence: 99%

Safety of external fixation during postoperative chemotherapy

Tsuchiya

Shirai

Morsy

et al. 2008

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

We studied the safety of external fixation during post-operative chemotherapy in 28 patients who had undergone distraction osteogenesis (17, group A) or vascularised fibular grafting (11, group B) after resection of a tumour. Four cycles of multi-agent post-operative chemotherapy were administered over a mean period of 14 weeks (6 to 27). The mean duration of external fixation for all patients was 350 days (91 to 828). In total 204 wires and 240 half pins were used. During the period of post-operative chemotherapy, 14 patients (11 in group A, 3 in group B) developed wire- and pin-track infection. A total of ten wires (4.9%) and 11 half pins (4.6%) became infected. Seven of the ten infected wires were in periarticular locations. External fixation during post-operative chemotherapy was used safely and successfully for fixation of a vascularised fibular graft and distraction osteogenesis in 27 of 28 patients. Post-operative chemotherapy for malignant bone tumours did not adversely affect the ability to achieve union or cause hypertrophy of the vascularised fibular graft and had a minimal effect on distraction osteogenesis. Only one patient developed osteomyelitis which required further surgery.

show abstract