Long-term Outcomes of Limb Salvage Treatment with Custom-made Extendible Endoprosthesis for Bone Sarcoma Around the Knee in Children

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2020 Jan 18

PMID 31948458

Citations 6

Authors

Changye Zou

Zhiqiang Zhao

Tiao Lin

Yongfu Huang

Xianbiao Xie

Junqiang Yin

Gang Huang

Bo Wang

Jingnan Shen

Affiliations

Soon will be listed here.

Abstract

Background: Limb salvage for bone sarcoma around the knee in skeletally immature children is challenging because of interference on two critical growth plates in the lower limb. This retrospective study aims to evaluate long-term outcomes and influence on growth of the lower limb of the cemented extendible endoprostheses.

Methods: Forty-five children with bone sarcoma around the knee, who underwent custom-made extendible endoprosthesis replacements, were included in this study. The average follow-up was 10.1 years. Survival, prosthetic-related complications and revision, functional outcomes, and influence on growth by prosthesis implantation were recorded.

Results: The 5-year disease-free survival and overall survival are 54.9% and 72.7%, and the 5-year prosthesis survival rate is 59.4%. The prosthesis was extended 4.2 cm in average. Limb length discrepancies of 20 patients were within 2 cm, and growth inhibition of proximal tibial epiphysis by passive implant insertion was observed. Aseptic loosening in 7 patients was the most significant complication. The Musculoskeletal Tumor Society score at last visit was 83.2%.

Conclusions: The use of custom-made extendible endoprosthesis provided good functional results for children with bone tumor around the knee. Further improvement of the prosthesis design and operation technique will help to decrease complication and gain better limb function.

Citing Articles

Incidence and management of secondary deformities after megaendoprosthetic proximal femur replacement in skeletally immature bone sarcoma patients.

Guder W, Engel N, Streitburger A, Polan C, Dudda M, Podleska L Arch Orthop Trauma Surg. 2024; 144(6):2501-2510.

PMID: 38700674 PMC: 11211162. DOI: 10.1007/s00402-024-05334-1.

Reconstruction of a 3D-printed endoprosthesis after joint-preserving surgery with intraoperative physeal distraction for childhood malignancies of the distal femur.

Gong T, Lu M, Min L, Luo Y, Tu C J Orthop Surg Res. 2023; 18(1):534.

PMID: 37496022 PMC: 10373418. DOI: 10.1186/s13018-023-04037-4.

Custom-made semi-joint prosthesis replacement combined ligament advanced reinforcement system (LARS) ligament reconstruction for the limb salvage surgery of malignant tumors in the distal femur in skeletal immature children.

Zan P, Shen J, Liu K, Wang H, Cai Z, Ma X Front Pediatr. 2023; 11:1168637.

PMID: 37416814 PMC: 10320852. DOI: 10.3389/fped.2023.1168637.

Three-dimensional printed customized uncemented unipolar prosthesis combined with ligament reconstruction for tumorous defect of the distal femur in children.

Li Z, Lu M, Zhang Y, You Q, Wang Y, Li L BMC Musculoskelet Disord. 2022; 23(1):1100.

PMID: 36527043 PMC: 9756496. DOI: 10.1186/s12891-022-06053-7.

Tibia Multiplanar Deformities and Growth Disturbance Following Expandable Endoprosthetic Distal Femur Replacement.

Shehadeh A, Al-Qawasmi M, Al Btoush O, Obeid Z J Clin Med. 2022; 11(22).

PMID: 36431210 PMC: 9699560. DOI: 10.3390/jcm11226734.

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