Modular Endoprostheses for Nonneoplastic Conditions: Midterm Complications and Survival

Gori, Marco De; Scoccianti, Guido; Frenos, Filippo; Bettini, Lidia; Familiari, Filippo; Gasparini, Giorgio; Beltrami, Giovanni; Cuomo, Pierluigi; Biase, Pietro De; Capanna, Rodolfo

doi:10.1155/2016/2606521

Cited by 13 publications

(8 citation statements)

References 25 publications

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“…Infection was the second most frequent complication reported in 7.6% of the cases (44 of 578 hips), in line with what have been previously reported [ 32 , 34 , 47 ]. Among those, further surgery was required in 84.1% of the cases (37 of 44 infections), while conservative treatment with suppressive antibiotic therapy was reported in 15.9% of the cases (7 of 44 infections).…”

Section: Discussionsupporting

confidence: 91%

Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

Mancino

Matteo

Mocini

et al. 2021

BMC Musculoskelet Disord

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Background Several studies have evaluated the survivorship and clinical outcomes of proximal femoral replacement (PFR) in complex primary and revision total hip arthroplasty with severe proximal femoral bone loss; however, there remains no consensus on the overall performance of this implant. We therefore performed a systematic review of the literature in order to examine survivorship and complication rates of PFR usage. Methods A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was conducted for English articles using various combinations of keywords. Results In all, 18 articles met the inclusion criteria. A total of 578 PFR were implanted. The all-cause reoperation-free survivorship was 76.6%. The overall complication rate was 27.2%. Dislocation was the most common complication observed and the most frequent reason for reoperation with an incidence of 12.8 and 7.6%, respectively. Infection after PFR had an incidence of 7.6% and a reoperation rate of 6.4%. The reoperation rate for aseptic loosening of the implant was 5.9%. Overall, patients had improved outcomes as documented by postoperative hip scores. Conclusion PFR usage have a relatively high complication rate, however, it remains an efficacious treatment option in elderly patients with osteoporotic bone affected by severe proximal femoral bone loss. Modular designs have shown reduced dislocations rate and higher survivorship free from dislocation. However, PFR should only be used as salvage procedure when no other reconstruction options are available.

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Section: Discussionsupporting

confidence: 91%

Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

Mancino

Matteo

Mocini

et al. 2021

BMC Musculoskelet Disord

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“…A great deal of progress has been made in the surgical reconstruction of bone defects resulted after resection of not only extremity bone sarcoma but also of metastatic lesions or other non-neoplastic conditions like severe bone loss due to trauma, infection and revision surgery, bone defects caused by nonunion, malunion, implant failure or peri-prosthetic fractures. 17,18 Every specific type of complication is under scrutiny and continuous research is aimed at developing new technologies and ways to prevent or treat this onerous situations.…”

Section: Discussionmentioning

confidence: 99%

Current review of surgical management options for extremity bone sarcomas

et al. 2019

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Modern surgical management of extremity bone sarcomas is governed by limb-sparing surgery combined with adjuvant and neoadjuvant chemotherapy. All the resection and reconstruction techniques have to achieve oncologic excision margins, with survival rates and functional results superior to amputation. The main reconstruction techniques of bone defects resulted after resection are: modular endoprosthetic reconstruction; bone graft reconstruction; bone transport; resection arthrodesis; and rotationplasty. Oncologic resection and modular endoprosthetic reconstruction are the generally approved surgical options adopted for the majority of cases in major specialized bone sarcoma centres. Good basic principles, efficient multidisciplinary approach and sustained research in the field can provide a better future for the challenge posed by extremity bone sarcoma treatment. Cite this article: EFORT Open Rev 2019;4:174-182. DOI: 10.1302/2058-5241.4.180048

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“…Conversely, articles were excluded if describing the use of proximal femoral replacement for the management of neoplastic pathology, if published in a language other than English, if regarding patients operated on for TFR, or if describing outcomes of fewer than five patients [ 26 ]. Two studies [ 24 , 27 ], despite being very informative, were excluded because a distinction between proximal and distal femoral replacements could not be made.…”

Section: Methodsmentioning

confidence: 99%

Proximal femoral replacement for non-neoplastic conditions: a systematic review on current outcomes

et al. 2022

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Proximal femoral replacement (PFR) is a well-established treatment for neoplasia of the proximal femur. The use of this surgical technique for non-neoplastic conditions has increased over the years. We carried out a systematic review of the literature to study the indications, complications, and functional results when PFR is used for non-neoplastic conditions. Twenty-seven studies were included in the review with a total of 828 PFRs with a mean follow-up of 50 months (range 1–225 months). The main indications were infection (28%), periprosthetic fracture (27%), aseptic loosening (22%), and fracture (16%). The rate of reoperation was 20.3% overall. The overall revision rate was 15.4%. The main complications were dislocation (10.2%) and infection (7.3%). After 2010, the rates of reoperation (25.5% versus 18.2%), loosening (9.4% versus 3.2%), and dislocation (15.7% versus 7.9%) were lower than before 2010. The 30-day mortality ranged from 0% to 9%. The hip function scores improved post-surgery. In conclusion, the use of PFR in non-neoplastic conditions remains a marginal tool, associated with low direct mortality and high complication rates, but we expect its use to increase in the near future.

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Modular Endoprostheses for Nonneoplastic Conditions: Midterm Complications and Survival

Cited by 13 publications

References 25 publications

Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

Current review of surgical management options for extremity bone sarcomas

Proximal femoral replacement for non-neoplastic conditions: a systematic review on current outcomes

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