Reconstruction Using Expandable Endoprostheses for Skeletally Immature Sarcoma Patients

Decilveo, Alexander P.; Szczech, Bartlomiej W; Golub, Ivan J; Wittig, James C.

doi:10.1016/j.jamcollsurg.2016.08.076

Cited by 2 publications

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“…Our functional outcomes were excellent with a mean MSTS scoring system of 26. This is similar to data previously reported in similar smaller series . MSTS score is a subjective scale and these encouraging results underline how patients are generally satisfied after DF NIEPR.…”

Section: Discussionsupporting

confidence: 90%

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Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Sambri

Staals

Medellin

et al. 2019

Journal of Surgical Oncology

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Aims The aim of this study is to assess outcomes of patients ≤12 years who undergo Stanmore noninvasive extendible endoprosthetic replacement of the distal femur (DF NIEPR). Patients and Methods A total of 101 children (mean age 9.6 years) were included. All complications which required further surgery were recorded. Clinical and functional outcomes were evaluated with Musculoskeletal Tumor Society (MSTS) scores at a mean follow‐up of 64 months (range 6‐174). Results Thirty‐one (30.7%) patients died at a mean of 33 months. Forty had prosthesis removed after a mean of 43 months (range, 7‐103). Attaining of the full lengthening potential before skeletal maturity was the most frequent reason for revision surgery, particularly in those with smaller lengthening potential (P = 0.039). Implant survival rate for other causes was 61.7% at 5 years and 45.0% at 10 years. At final follow‐up mean MSTS score was 26 (range, 13‐29). Twenty‐two (21.5%) patients had a final limb‐length discrepancy (LLD) > 2 cm. Conclusions DF NIEPR produces a good functional outcome, with the prevention of major LLD at skeletal maturity in the majority of the cases. We suggest patient selection criteria to account for the stage of the disease due to the high cost of the NIEPR, and high percentage requiring revision, and a 60% mortality rate in those patients presenting with distant disease burden.

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Section: Discussionsupporting

confidence: 90%

“…Moreover, the revision of the prosthesis to a new NIEPR can be a viable but more expensive option to continue the lengthening of the femur. This is similar to data previously reported in similar smaller series 2,8,21. MSTS score is a subjective scale and these encouraging results underline how patients are generally satisfied after DF NIEPR.…”

supporting

confidence: 90%

Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Sambri

Staals

Medellin

et al. 2019

Journal of Surgical Oncology

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“…[ 14 ] Minimal and non-invasive expandable endoprostheses have been developed to counter LLD. [ 15 ] Although there are few reports of custom-made expandable proximal femoral endoprostheses, the functional results so far have been good. [ 16 ] A unique complication of hip arthroplasty in early childhood is the ongoing growth of the acetabulum.…”

Section: Discussionmentioning

confidence: 99%

Hip-preserving reconstruction of the proximal femur with a vascularized fibula autograft and liquid-nitrogen-treated tumor bearing bone

Ayvaz¹,

Göker

Leblebicioğlu³

2021

Jt Dis Relat Surg

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Primary bone malignancies in children pose numerus challenges for orthopedic oncology surgeons. Limb salvage surgery is widely preferred, and biological reconstruction methods such as the vascularized autografts, allografts, radiated or frozen tumor bearing autografts bear the advantage of preserving children's own anatomy. [1][2][3][4] In such cases, conserving the joint and epiphysis may potentially improve the outcome of otherwise debilitating surgeries. [1] In this article, we present a pediatric case of epiphysissparing biological reconstruction of the proximal femur. CASE REPORTA five-year-old male patient who had a twomonth-old history of inability to bear weight with the left lower extremity presented to our A five-year-old boy with Ewing sarcoma of the proximal femur was operated at our institution with limb-sparing surgery and biological reconstruction of the proximal femur with a vascularized fibular autograft. During this procedure, the proximal femur was soaked in liquid nitrogen which was subsequently fixed to the fibular autograft, while the epiphysis of the femoral head was spared. To the best of our knowledge, this is the first report of epiphysis-sparing surgery of the proximal femur via a vascularized fibular autograft surrounded by a liquid nitrogen-treated tumor bearing bone autograft. Three years postoperatively, the patient remains disease-free, has a full weight-bearing extremity with good function, and a remodeled proximal femur with minimal deformity. There are no radiological or clinical signs indicative of femoral head osteonecrosis. In conclusion, hip-sparing biological reconstruction is a successful method of limb preservation as an alternative to tumor endoprostheses.

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Reconstruction Using Expandable Endoprostheses for Skeletally Immature Sarcoma Patients

Cited by 2 publications

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Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Hip-preserving reconstruction of the proximal femur with a vascularized fibula autograft and liquid-nitrogen-treated tumor bearing bone

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