Resurfaced Allograft-Prosthetic Composite for Proximal Tibial Reconstruction in Children

Abstract

In children and young teenagers with bone tumors of the proximal part of the tibia requiring an intra-articular resection, knee reconstruction with a resurfaced allograft-prosthetic composite may represent a valid alternative to conventional megaprostheses or to osteoarticular allograft.

Review of Osteosarcoma and Current Management

“…The allograft side allows for a stronger and more complete reconstruction of the periarticular soft-tissue envelope and incorporates into the patient’s host bone, while the prosthetic side creates a stable and predictable joint articulation. These implants represent a high degree of complexity for the surgeon, but have been shown by several centers to provide a stable reconstruction with similar failure rates to other methods [106, 107]. …”

Cost‐utility of osteoarticular allograft versus endoprosthetic reconstruction for primary bone sarcoma of the knee: A markov analysis

“…We did not include allograft‐prosthesis composites or expandable prostheses as reconstructive options in our model. We chose not to include these options because the potential implant and allograft combinations and calculating the cost of an expandable prosthesis would be challenging with any assumptions based on likely even smaller data sets than our current data tables . We also did not include custom or silver‐coated endoprostheses as the true cost of these implants are difficult to ascertain.…”

“…We chose not to include these options because the potential implant and allograft combinations and calculating the cost of an expandable prosthesis would be challenging with any assumptions based on likely even smaller data sets than our current data tables. [28][29][30] We also did not include custom or silver-coated endoprostheses as the true cost of these implants are difficult to ascertain. We also did not include the use of autoclaved or irradiated re-implanted autograft bone reconstructions in our model.…”

Reconstruction Following Tumor Resections in Skeletally Immature Patients

“…42 For reconstructions about the knee, however, most implant systems require instrumentation across the joint for a congruent articulation. This introduces a potential disruption of the adjacent physis, which can be mitigated by placement of a highly polished press-fit stem in the central portion of the physis to allow continued physeal growth [43][44][45] (Figure 8).…”