Revisions of endoprosthetic reconstructions after limb salvage in musculoskeletal oncology

Abstract

Of 91 limb-salvage procedures using prosthetic reconstructions because of primary or metastatic bone and soft-tissue tumors 26 revisions were performed in 16 patients. Revision was due to polyethylene wear (9 cases), aseptic loosening (8 cases), recurrent hip dislocation (3 cases), prosthetic stem fracture (2 cases), infection (2 cases), leg length discrepancy (1 case), and traumatic dislocation of a saddle prosthesis (1 case). The follow-up period for tumor control varied from 1.5 to 22 years with a median of 13.5 years. The follow-up period after the last revision operation varied from 0.5 to 12 years with a median of 3 years. At the last follow-up, the functional results had deteriorated compared with after the primary operation in 5 patients and had improved in 2 patients. In the remaining patients, the results did not change.

Revision of Broken Knee Megaprostheses: New Solution to Old Problems

“…The revisions have also been successful, with a low chance of amputation and a functional score the same or slightly lower than after primary surgery, with a risk of failure similar to that after primary surgery. Our observations match those of others (Table 3), with only a minor or no loss of function [15,17,20,21]. In 1991 Inglis and Walker [12] reported poor outcomes with a revision for hinged prostheses.…”

Function and complications after ablative and limb-salvage therapy in lower extremity sarcoma of bone

“…Recently, we reported results with endoprosthetic revisions: 24 revisions had been performed in 14 patients with a malignancy of the lower extremity. Two patients ultimately had an amputation; in 2 of the other patients, function deteriorated after the last revision compared to after the primary operation, in 2 function improved, and in 8 function remained the same [29].…”

Revision of the Kotz type of tumour endoprosthesis for the lower limb

“…Although the number of revision operations is increasing, information concerning the outcome after aseptic loosening is limited. 25,27,29 We present a retrospective study of the complication rates and the functional and radiological outcome after cementless revision operations for aseptic loosening.…”