Reconstruction Using Expandable Endoprostheses for Skeletally Immature Patients With Sarcoma

Decilveo, Alexander P.; Szczech, Bartlomiej W; Topfer, Jacob; Wittig, James C.

doi:10.3928/01477447-20161017-02

Cited by 10 publications

(4 citation statements)

References 29 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%

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%

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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“…Expandable prosthesis, designed for skeletally immature patients in 1976 4 , has greatly evolved over decades 6 , 8 , 9 . Yet the complication rate of expandable prosthesis remains higher than that of the standard static prosthesis 10 , 11 , and only a few cases have been reported for skeletal mature patients 12 , 13 . Besides, expandable prostheses are not available in China currently.…”

Section: Introductionmentioning

confidence: 99%

An innovative staged prosthetic lengthening reconstruction strategy for osteosarcoma-related leg discrepancy

Xu,

Li,

et al. 2024

Sci Rep

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Correction of leg length discrepancy (LLD) in skeletally mature patients with osteosarcoma was rarely reported and quite challenging. This study aimed to propose a treatment strategy of staged lengthening and reconstruction with a standard static prosthesis to address LLD and restore limb function. It also evaluated the effectiveness of the strategy in terms of leg lengthening, functional outcomes, and complications. The strategy for lengthening included three stages. In stage 1, the previous prosthesis was removed and an external fixator with a temporary rod-cement spacer was placed. In this stage, the external fixator was used to lengthen the limb to the appropriate length. In stage 2, the external fixator was removed and the old rod-cement spacer was replaced with a new one. In stage 3, the rod-cement spacer was removed and the standard static prosthesis was planted. Nine skeletally mature distal femoral osteosarcoma patients with unacceptable LLD were treated in our institution from 2019 to 2021. We performed a chart review on nine patients for the clinical and radiographic assessment of functional outcomes, LLD, and complications. The mean (range) leg lengthening was 7.3 cm (3.6–15.6). The mean (range) LLD of the lower limbs decreased from 7.6 cm (4.1–14.2) before the lengthening to 0.3 cm (− 0.3 to 2.1) at the final follow-up with statistical significance (P = 0.000). The mean (range) Musculoskeletal Tumor Society score improved from 30.3% (16.7%–53.3%) before the lengthening to 96.3% (86.7%–100%) at the final follow-up with statistical significance (P = 0.000). Three patients (33.3%) had a minor complication; none needed additional surgical intervention. In the short term, the current staged lengthening and reconstruction with standard static prosthesis provided satisfactory functional outcomes and LLD correction with few complications. The long-term effects of this method need further exploration.

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“…Expandable prosthesis, designed for skeletally immature patients in 1976 4 , has greatly evolved over decades 6,8,9 . Yet the complication rate of expandable prosthesis remains higher than that of the standard static prosthesis 10,11 , and only a few cases have been reported for skeletal mature patients 12,13 . Besides, expandable prostheses are not available in China currently.…”

Section: Introductionmentioning

confidence: 99%

“…The mean duration from the second surgery in stage 2 to the third surgery in stage 3 was 6.1 months (3.1-11.7). The mean (range) duration from the rst surgery to the third surgery was 12 months(7)(8)(9)(10)(11)(12)(13)(14). The mean (range) follow-up was 131 months (21-246) (from the initial primary tumor surgery) and 20 months (3-70) (from the third surgery in stage 3).…”

mentioning

confidence: 99%

Unacceptable leg length discrepancy in skeletally mature patients with osteosarcoma?

Yang

et al. 2023

Preprint

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Introduction Correction of leg length discrepancy (LLD) in skeletally mature patients with osteosarcoma was rarely reported and quite challenging. This study aimed to propose a treatment strategy of staged lengthening and reconstruction with a standard static prosthesis to address LLD and restore limb function. It also evaluated the effectiveness of the strategy in terms of leg lengthening, functional outcomes, and complications. Methods The strategy for lengthening included three stages. In stage 1, the previous prosthesis was removed and an external fixator with a temporary rod-cement spacer was placed. In this stage, the external fixator was used to lengthen the limb to the appropriate length. In stage 2, the external fixator was removed and the old rod-cement spacer was replaced with a new one. In stage 3, the rod-cement spacer was removed and the standard static prosthesis was planted. Nine skeletally mature distal femoral osteosarcoma patients with unacceptable LLD were treated in our institution from 2019 to 2021. We performed a chart review on nine patients for the clinical and radiographic assessment of functional outcomes, LLD, and complications. Results The mean (range) leg lengthening was 7.3 cm (3.6–15.6). The mean (range) LLD of the lower limbs decreased from 7.6 cm (4.1–14.2) before the lengthening to 0.3 cm (–0.3 to 2.1) at the final follow-up with statistical significance (P = 0.000). The mean (range) Musculoskeletal Tumor Society score improved from 30.3% (16.7%–53.3%) before the lengthening to 96.3% (86.7%–100%) at the final follow-up with statistical significance (P = 0.000). Three patients (33.3%) had a minor complication; none needed additional surgical intervention. Conclusions In the short term, the current staged lengthening and reconstruction with standard static prosthesis provided satisfactory functional outcomes and LLD correction with few complications. The long-term effects of this method need further exploration. Level of Evidence Level IV, therapeutic study

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Reconstruction Using Expandable Endoprostheses for Skeletally Immature Patients With Sarcoma

Cited by 10 publications

References 29 publications

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

An innovative staged prosthetic lengthening reconstruction strategy for osteosarcoma-related leg discrepancy

Unacceptable leg length discrepancy in skeletally mature patients with osteosarcoma?

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