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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 8, 1084-1089.
doi: 10.1302/0301-620X.90B8.20240  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Endoprosthetic replacement for primary tumours around the knee

EXPERIENCE FROM PEKING UNIVERSITY

W. Guo, MD, PhD, Professor1; T. Ji, MD, Orthopaedic Surgeon1; R. Yang, MD, Associate Professor1; X. Tang, MD, Orthopaedic Surgeon1; and Y. Yang, MD, Orthopaedic Surgeon1

1 Musculoskeletal Tumor Centre, People’s Hospital, Peking University, 11# Xizhimen Nan Road, Xicheng District, Beijing, 100044, China.

Correspondence should be sent to Professor W. Guo; e-mail: sarcomasurgeon_cn{at}yahoo.com.cn

In developing countries locally-made low-cost prostheses are mainly used in limb-salvage surgery to alleviate the economic burden.

We retrospectively collected data on 104 patients treated by limb-salvage surgery between July 1997 and July 2005. We used a locally-designed and fabricated stainless-steel endoprosthesis in each case. Oncological and functional outcomes were evaluated at a mean follow-up of 47 months (12 to 118).

A total of 73 patients (70.2%) were free from disease, nine (8.7%) were alive with disease, 19 (18.2%) had died from their disease and three (2.9%) from unrelated causes. According to the Musculoskeletal Tumor Society scoring system, the mean functional score was 76.3% (SD 17.8). The five-year survival for the implant was 70.5%. There were nine cases (8.7%) of infection, seven early and two late, seven (6.7%) of breakage of the prosthesis, three (2.9%) of aseptic loosening and two (1.9%) of failure of the polyethylene bushing. Multivariate analysis showed that a proximal tibial prosthesis and a resection length of 14 cm or more were significant negative prognostic factors.

Our survival rates and Musculoskeletal Tumor Society functional scores are similar to those reported in the literature. Although longer follow-up is needed to confirm our results, we believe that a low-cost custom-made endoprosthesis is a cost-effective and reliable reconstructive option for limb salvage in developing countries.




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M. D. Sewell, B. G. I. Spiegelberg, S. A. Hanna, W. J. S. Aston, W. Bartlett, G. W. Blunn, L. A. David, S. R. Cannon, and T. W. R. Briggs
Total femoral endoprosthetic replacement following excision of bone tumours
J Bone Joint Surg Br, November 1, 2009; 91-B(11): 1513 - 1520.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General