Surgical and Functional Outcomes After Limb-Preservation Surgery for Tumor in Pediatric Patients

Groundland, John; Ambler, Steve; Houskamp, LT Daniel J.; Orriola, John J.; Binitie, Odion; Letson, G. Douglas

doi:10.2106/jbjs.rvw.o.00013

Cited by 55 publications

(51 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Limb‐sparing with a metal endoprosthesis as recently reported lead to complications in 96% of operated dogs . These complication rates are similar to those published in humans, where revisions are warranted in up to 55% of patients . Complications can lead to serious consequences, such as amputations required in 2 dogs in our series.…”

Section: Discussionsupporting

confidence: 86%

Long‐term outcome of dogs treated with ulnar rollover transposition for limb‐sparing of distal radial osteosarcoma: 27 limbs in 26 dogs

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 86%

Long‐term outcome of dogs treated with ulnar rollover transposition for limb‐sparing of distal radial osteosarcoma: 27 limbs in 26 dogs

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Surgical options have shifted from amputation to limb salvage. Reconstruction strategies for this specific population include rotationplasty, megaprosthesis implantation with expandable mechanism or fixed length, allograft, and staged distraction osteogenesis. Rotationplasty and expandable endoprosthesis have been successfully used to treat skeletally immature patients with osteosarcoma of the distal femur.…”

Section: Discussionmentioning

confidence: 99%

“…To address LLD following limb salvage surgery, expandable prostheses have been developed. However, besides the high complication rate, up to 50% of patients who have expandable prosthesis reconstruction do not undergo further lengthening procedures due to oncological failures or overestimation of expected LLD. In addition, small degrees of LLD up to 2.2 cm can be well compensated by mechanism of pelvic obliquity, and the children usually have a normal gait.…”

Section: Discussionmentioning

confidence: 99%

Limb Salvage Using Non‐hinged Endoprosthesis and Staged Correction of Leg‐length Discrepancy for Children with Distal Femoral Malignant Tumors

Yang

et al. 2019

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveLimb salvage in pediatric patients remains a challenge. We describe a staged strategy. The procedure includes: (i) tumor removal and non‐hinged static endoprosthesis reconstruction; (ii) leg length discrepancy (LLD) correction by shoe lift or distraction osteogenesis; and (iii) maturity reconstruction by regular endoprosthesis. The aim of the study was to investigate the results of non‐hinged static megaprosthesis reconstruction and staged LLD correction in the treatment of malignant tumors in the distal femur in children.MethodsNon‐hinged megaprostheses were implanted in 12 pediatric patients with osteosarcoma in the distal femur. The prosthesis consists of a femoral component with constrained condylar knee (CCK) design, and a tibial component with a small‐diameter press‐fit stem and derotation fins. A posterior stabilizing polyethylene component is fixed on the tibial component. The cases were prospectively followed up with focus on the growth rate of adjacent uninvolved bone in the salvaged limb, joint stability, knee stability, function outcome, length discrepancy, and surgery‐related complications.ResultsThere were five girls and seven boys included in the study, with an average age at the time of primary surgery of 10.0 years (range, 8–12 years). All the tumors were located in the distal femur. The average follow up was 76.3 months (range, 24–139 months). The Ligament Augmentation and Reconstruction System (LARS) ligament was used in two patients to enhance the soft tissue reattachment and reconstruct medial collateral ligament (MCL). Ten patients were alive at the final follow‐up and two had died of lung metastases. Expected LLD was 6.7 cm (range, 3.0–13.2 cm) at initial surgery. At the final follow‐up, nine patients reached skeletal maturity and the actual LLD at the femur was 5.3 cm (range, 3.0–10.1 cm), excluding 1 cm correction at initial surgery by endoprosthesis. The proximal tibia physis showed an average of 86.7% (range, 56.5%–100%) growth of the contralateral side. The mean reduction in tibial length was 1.2 cm (range, 0.5–4.7 cm). Six patients received distraction osteogenesis at a mean length of 5.4 cm (range, 3.0–9.1 cm). Range of knee movement was between 85° and 125°, with an average of 102.5°. The Musculoskeletal Tumor Society 93 score of patients alive was 80.6 (range, 60–90).ConclusionNon‐hinged static megaprosthesis followed by LLD correction with shoe lift or staged distraction osteogenesis appears to be an alternative option to treat children with malignant bone tumors around the knee.

show abstract

“…The rate of nonunion was low compared with the literature on non-vascularized grafts. 22,23 No cases of infection were reported. The major drawback of the current method of reconstruction as compared with the Capanna technique (combined free fibular flap and bone allograft) is the necessary prolonged period of protected weight bearing for these children until their fibular graft hypertrophies with an average of 13 months.…”

Section: Discussionmentioning

confidence: 99%

Use of Vascularized Fibular Free Flap in the Reconstruction of the Femur in Pediatric and Adolescent Bone Sarcomas: Complications and Functional Outcome

Ghoneimy

Sherbiny

Kamal

2018

J reconstr Microsurg

View full text Add to dashboard Cite

show abstract

Surgical and Functional Outcomes After Limb-Preservation Surgery for Tumor in Pediatric Patients

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 55 publications

References 102 publications

Long‐term outcome of dogs treated with ulnar rollover transposition for limb‐sparing of distal radial osteosarcoma: 27 limbs in 26 dogs

Long‐term outcome of dogs treated with ulnar rollover transposition for limb‐sparing of distal radial osteosarcoma: 27 limbs in 26 dogs

Limb Salvage Using Non‐hinged Endoprosthesis and Staged Correction of Leg‐length Discrepancy for Children with Distal Femoral Malignant Tumors

Use of Vascularized Fibular Free Flap in the Reconstruction of the Femur in Pediatric and Adolescent Bone Sarcomas: Complications and Functional Outcome

Contact Info

Product

Resources

About