Late Complications and Survival of Endoprosthetic Reconstruction after Resection of Bone Tumors.

00:54 EDT 29th July 2015 | BioPortfolio

Summary of "Late Complications and Survival of Endoprosthetic Reconstruction after Resection of Bone Tumors."


BACKGROUND:
While complications following massive endoprosthetic reconstruction have been previously described, the incidence and effects of these complications over extended periods of time have not been well characterized in large series. QUESTIONS/
PURPOSES:
We therefore determined: (1) incidence and types of complications; (2) relative risk of complications; (3) likelihood of secondary complications; (4) whether modularity altered such complications; (5) implant failure and limb salvage rates and (6) implant survival over extended followup.
METHODS:
We retrospectively reviewed 232 patients (241 implants: 50 custom,191 modular) who underwent endoprosthetic reconstruction for malignant and aggressive bone tumors between 1980 and 2002. Complications were classified as infection, mechanical, superficial soft tissue, deep soft tissue, or dislocation. Survival was determined by Kaplan-Meier analysis. Minimum followup was 5 years (mean: 10 years; range: 5-27 years).
RESULTS:
One hundred thirty-seven of 232 patients (59%) underwent a single reconstruction. Ninety-five patients had 242 additional procedures. Forty-four revised patients retained their original prosthesis. Limb salvage rate was 90%; implant failure (removal of the cemented part) was seen in 29% (70/241) with a median survival of 190 months. Twenty-five of 50 custom implants failed (8 then failed again) while 30/180 modular implants failed (7 then failed again). Of 70 instances of implant failure, 38/70 were mechanical, 27/70 infectious. Risk of infection increased 30% after a second procedure; 16 of 24 amputations were performed because of infection.
CONCLUSIONS:
Mechanical complications were the most common cause of implant failure. Infection was the leading cause of both complication and amputation; risk of infection increased substantially with revision surgery. Modular implants had fewer mechanical complications, thus leading to fewer revisions and subsequent infections. LEVEL OF
EVIDENCE:
Level III, therapeutic study. See the guidelines for authors for a complete description of levels of evidence.

Affiliation

Washington Cancer Institute at Washington Hospital Center, Washington, DC, USA.

Journal Details

This article was published in the following journal.

Name: Clinical orthopaedics and related research
ISSN: 1528-1132
Pages:

Links

PubMed Articles [14393 Associated PubMed Articles listed on BioPortfolio]

Percutaneous Sclerotherapy With Absolute Alcohol to Treat Aneurysmal Bone Cyst of the Frontal Bone.

Aneurysmal bone cysts (ABCs) rarely occur in the cranial bone. Surgical resection can lead to bone defects, deformities, functional abnormalities, and so on. This article describes a frontal ABC in a ...

Effect of aging on the osteoinductive activity of recombinant human bone morphogenetic protein-2 in rats.

Bone morphogenetic proteins may hold broad potential for use in the reconstruction of bone defects resulting from tumor resection or trauma and in assisting bone healing thanks to methods enabling the...

Long-term progression and survival following Norwood Single Ventricle Reconstruction.

Much data exist concerning Norwood discharge mortality. Less is known about late survival. Examining the available data in light of the Single Ventricle Reconstruction trial is insightful as focus shi...

Early Fat Grafting for Augmentation of Orbitozygomatic Region in Treacher Collins Syndrome.

This report presents our preliminary experience with the effect of early fat grafting (FG) (at ≥6 months of age) in timely bone reconstruction of the orbitozygomatic area in patients with Treacher C...

A new technique using mesh for extensor reconstruction after proximal tibial resection.

Proximal tibial reconstruction following wide resection in both malignant and benign tumors presents difficulties mainly due to both patellar tendon reconstruction and high risk of infection. The purp...

Clinical Trials [4309 Associated Clinical Trials listed on BioPortfolio]

Clinical Study of FRC Implant to Treat Skull Bone Defects

Bioactive fibre-reinforced composite implant is used for reconstruction of skull bone defects and orbital floor defects. Functional and aesthetic outcome is assessed by patient and doctor...

Reconstruction Implant Bone After Removal Using Porous Titanium Prosthesis

This trial will study the reconstruction of the anterior part of the mandible and the adjacent soft tissue parts by a mandibular prosthesis made in porous titanium, associated or not, to a...

Delayed-Immediate Breast Reconstruction

The goal of this clinical research study is to evaluate a new two-stage approach (delayed-immediate reconstruction) to breast reconstruction in women who may require post-mastectomy radiat...

Bone Tunnel Widening Following ACL Reconstruction

Hypothesis 1: There is less tunnel-widening with bone–patella tendon–bone graft compared with the hamstring graft when the same fixation method is used. Tunnel widening is greater wit...

Intralesional Resection in Treating Patients With Chondrosarcoma of the Bone

RATIONALE: Intralesional resection is a less invasive type of surgery for chondrosarcoma of the bone and may have fewer side effects and improve recovery. PURPOSE: This phase II trial is ...

Medical and Biotech [MESH] Definitions

Fixation of the ANTERIOR CRUCIATE LIGAMENT, during surgical reconstruction, by the use of a bone- patellar tendon autograft.

Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.

The eight bones of the wrist: SCAPHOID BONE; LUNATE BONE; TRIQUETRUM BONE; PISIFORM BONE; TRAPEZIUM BONE; TRAPEZOID BONE; CAPITATE BONE; and HAMATE BONE.

The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host.

Endovascular reconstruction of an artery, which may include the removal of atheromatous plaque and/or the endothelial lining as well as simple dilatation. These are procedures performed by catheterization. When reconstruction of an artery is performed surgically, it is called ENDARTERECTOMY.


Advertisement
 

Relevant Topics

Osteoporosis
Latest News Clinical Trials Research Drugs Reports Corporate
Osteoporosis is a disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse. Follow and track&n...

Infectious-diseases
Latest News Clinical Trials Research Drugs Reports Corporate
Antiretroviral Therapy Clostridium Difficile Ebola HIV & AIDS Infectious Diseases Influenza Malaria Measles Sepsis Swine Flu Tropical Medicine Tuberculosis Infectious diseases are caused by pathogenic...

Advertisement
 

Searches Linking to this Article