Relationship between magnitude of resection, complication, and prosthetic survival after prosthetic knee reconstructions for distal femoral tumors

Kawai, Akira; Lin, Patrick P.; Boland, Patrick J.; Athanasian, Edward A.; Healey, John H.

doi:10.1002/(sici)1096-9098(199902)70:2<109::aid-jso9>3.0.co;2-x

Cited by 99 publications

(116 citation statements)

References 28 publications

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“…Overall EPR survivability for distal femoral reconstruction varies greatly in the literature (Table 3). Published results show a survivorship of 75-90% at 5 years [10,13,15,16,20]. The 5-year survival of 83.5% in CPS implants is encouraging in light of these numbers.…”

Section: Discussionmentioning

confidence: 95%

Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?

Pedtke

Wustrack

Fang

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Failure of endoprosthetic reconstruction with conventional stems due to aseptic loosening remains a challenge for maintenance of limb integrity and function. The Compress 1 implant (Biomet Inc, Warsaw, IN, USA) attempts to avoid aseptic failure by means of a unique technologic innovation. Though the existing literature suggests survivorship of Compress 1 and stemmed implants is similar in the short term, studies are limited by population size and followup duration.Questions/purposes We therefore compared (1) the rate of aseptic failure between Compress 1 and cemented intramedullary stems and (2) evaluated the overall intermediate-term implant survivorship. Methods We reviewed 26 patients with Compress 1 implants and 26 matched patients with cemented intramedullary stems. The patients were operated on over a 3-year period. Analysis focused on factors related to implant survival, including age, sex, diagnosis, infection, aseptic loosening, local recurrence, and fracture. Minimum followup was 0.32 years (average, 6.2 years; range, 0.32-9.2 years).

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Section: Discussionmentioning

confidence: 95%

Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?

Pedtke

Wustrack

Fang

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…6), resection of extra tissue, such as uninvolved joint surfaces, can have major long-term functional consequences [10,13,14,21,27]. Here, we evaluated whether a custom jigassisted bone tumor resection technique reproduces a welldefined preoperative plan more accurately and consistently than traditional manual resection techniques.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique: Computer-generated Custom Jigs Improve Accuracy of Wide Resection of Bone Tumors

Khan

Lipman

Pearle

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Manual techniques of reproducing a preoperative plan for primary bone tumor resection using rudimentary devices and imprecise localization techniques can result in compromised margins or unnecessary removal of unaffected tissue. We examined whether a novel technique using computer-generated custom jigs more accurately reproduces a preoperative resection plan than a standard manual technique. Description of TechniqueUsing CT images and advanced imaging, reverse engineering, and computer-assisted design software, custom jigs were designed to precisely conform to a specific location on the surface of partially skeletonized cadaveric femurs. The jigs were used to perform a hemimetaphyseal resection. Methods We performed CT scans on six matched pairs of cadaveric femurs. Based on a primary bone sarcoma model, a joint-sparing, hemimetaphyseal wide resection was precisely outlined on each femur. For each pair, the resection was performed using the standard manual technique on one specimen and the custom jig-assisted technique on the other. Superimposition of preoperative and postresection images enabled quantitative analysis of resection accuracy. Results The mean maximum deviation from the preoperative plan was 9.0 mm for the manual group and 2.0 mm for the custom-jig group. The percentages of times the maximum deviation was greater than 3 mm and greater than 4 mm was 100% and 72% for the manual group and 5.6% and 0.0% for the custom-jig group, respectively. Conclusions Our findings suggest that custom-jig technology substantially improves the accuracy of primary bone tumor resection, enabling a surgeon to reproduce a given preoperative plan reliably and consistently.

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“…We found several surveys with a low level of evidence (evidence level III or IV). [1][2][3][4][5]8,10,11,20,21,[22][23][24][25] This reflects the challenge and the difficulty involved in clinical surveys on orthopedic oncology.…”

Section: Discussionmentioning

confidence: 99%

“…6,8,9 In the real practice of orthopedic oncology, the approach to the topic involves obstacles since surveys focus on survival, resection size and functional scores of the affected limb, which transforms the topic into a field of research and exploration. 1,2,5,[10][11][12] However, it appears to us to be difficult to conduct clinical studies without multicentric collaboration. Systematic reviews are a summary of the literature that addresses the available data and promotes the acquisition of rational information for clinical decisions.…”

Section: Introductionmentioning

confidence: 99%

Complicações das endopróteses em pacientes com tumores ósseos do joelho

et al. 2011

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Non-conventional endoprostheses (NCE) are frequently used in orthopedic oncology. The complications associated with this procedure have prompted research, due to the fact that it is commonly performed on young patients, with a higher survival rate. We conducted a systematic review of the literature, searching for the best scientific evidence on the subject. The research was carried out in the following databases: MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of randomized controlled trials (CCTR), seeking to identify studies that report complications, and compare patellar resurfacing versus retention. The studies were selected according to the Article received on 9/5/09 and approved on 5/27/10 best methodological quality that exists for the subject. One hundred and forty six (146) studies were evaluated. No randomized clinical trial was found. We conducted a qualitative and quantitative evaluation of the work found (evidence levels IV and V). We used the Mann-Whitney U test for the statistical analysis. The results indicate a need for further studies that will enable us to reach a more solid conclusion. The rate of complications after NCE can be considered high, despite the low quality of the studies, as demonstrated by the studies that exist in the literature.

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Relationship between magnitude of resection, complication, and prosthetic survival after prosthetic knee reconstructions for distal femoral tumors

Cited by 99 publications

References 28 publications

Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?

Aseptic Failure: How Does the Compress® Implant Compare to Cemented Stems?

Surgical Technique: Computer-generated Custom Jigs Improve Accuracy of Wide Resection of Bone Tumors

Complicações das endopróteses em pacientes com tumores ósseos do joelho

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