Systematic Review of Proximal Femoral Arthroplasty for Non-Neoplastic Conditions

Korim, M.T.; Esler, Colin; Ashford, Robert U.

doi:10.1016/j.arth.2014.06.012

Cited by 55 publications

(86 citation statements)

References 23 publications

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“…Our results slightly differ from those of the previously published literature: Berend and Lombardi [18] found encouraging results with an overall reoperation-free survival of 97% at 1 year, 95% at 2 years, and 83% at 5 years after distal femoral replacement. On the contrary the systematic reviews by Korim et al [6, 7] pointed out a mean failure rate of 76% at 3.8 years for proximal femoral prostheses [6] and 83% at 3.3 years for distal femoral prostheses [7]. We may explain such discrepancies by assuming that our survival analysis was carried out considering failures according to Henderson et al [16] rather than overall reoperations as endpoints.…”

Section: Discussionmentioning

confidence: 90%

“…Megaprostheses are currently gaining momentum, at least in high-volume centers, as a useful and effective reconstructive strategy for severe bone loss following nonneoplastic conditions, such as a failed joint replacement or fracture, complex periprosthetic fractures, and severe instabilities of distal femoral prostheses. Though promising results have been published [2–14], the use of megaprostheses in such cases should be considered as a limb salvage option in carefully selected patients, when other surgical options are unfeasible [6]. …”

Section: Discussionmentioning

confidence: 99%

“…Specifically, patients were reviewed for both complications and failure of their megaprosthetic implant. Complications were classified according to the system by Henderson et al [16], as previously modified for its use in nonneoplastic conditions [6], into soft-tissue complications (type 1), aseptic loosening (type 2), structural complications (type 3), and perimegaprosthetic infections (type 4). Failed reconstructions were defined as those having required complete revision of the endoprosthesis, unplanned revision of a failed portion of the endoprosthesis, fixation of a periprosthetic fracture, soft-tissue reconstruction to restore joint stability, endoprosthetic removal without revision, and amputation [16].…”

Section: Methodsmentioning

confidence: 99%

“…Two recent systematic reviews [6, 7] focused on the widespread use of modular endoprostheses for nonneoplastic conditions. Authors found an overall midterm survival rate of 76% for proximal femoral prostheses [6] and 83% for distal femoral prostheses [7].…”

Section: Introductionmentioning

confidence: 99%

“…Authors found an overall midterm survival rate of 76% for proximal femoral prostheses [6] and 83% for distal femoral prostheses [7]. Notably, posttraumatic, infective, and periprosthetic conditions have peculiar characteristics that are very different to those of oncologic patients.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Modular Endoprostheses for Nonneoplastic Conditions: Midterm Complications and Survival

Gori

Scoccianti

Frenos

et al. 2016

BioMed Research International

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The use of modular endoprostheses is a viable option to manage both tumor resection and severe bone loss due to nonneoplastic conditions such as fracture sequelae, failed osteoarticular grafts, arthroplasty revisions, and periprosthetic fractures. We sought to investigate both midterm complications and failures occurred in 87 patients who underwent a megaprosthetic reconstruction in a nonneoplastic setting. After a mean follow-up of 58 (1–167) months, overall failure-free survival was 91.5% at 1 year, 80% at 2 years, 71.6% at 5 years, and 69.1% at 5 and 10 years. There was no significant difference in the survival rate according to the diagnosis at the index procedure (p = 0.921), nor to the reconstruction site (p = 0.402). The use of megaprostheses in a postneoplastic setting did not affect survival rate in comparison with endoprosthetic reconstruction of pure nonneoplastic conditions (p = 0.851). Perimegaprosthetic infection was the leading complication, occurring in 10 (11.5%) patients and implying a megaprosthetic revision in all but one case. Physicians should consider these results when discussing with patients desired outcomes of endoprosthetic reconstructions of a nonneoplastic disease.

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