Abstract
We analysed 133 patients treated with resection and endoprosthetic proximal tibial replacement from 1988 to 2000. Mean age was 22.3 years and osteosarcoma was the most common tumour. Average follow-up was 59.4 months. An excellent functional result was achieved in 63 patients and a good result in 36. The number of patients who had no evidence of disease was 102. Twenty-four patients died due to disease. Infection was the most common complication, followed by periprosthetic fracture and aseptic loosening. The 5-year limb survival rate was 85.5%.
Résumé
Nous avons analysé 133 malades, traités par résection et remplacement endoprothétique du tibia proximal de 1988 à 2000. L'âge moyen était 22.3 ans et l'ostéosarcome était la tumeur la plus fréquente. Le délai moyen de suivi était 59.4 mois. Un excellent résultat fonctionnel a été obtenu pour 63 malades et un bon résultat pour 36. Le nombre de malades qui n'avaient pas de signe de maladie était 102. Vingt-quatre malades sont morts à cause de la maladie. L'infection était la complication la plus fréquente, suivi par les fractures périprothétiques et le descellement aseptique. La présence du membre à 5 ans était de 85.5%.
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References
- 1.Abudu A, Carter SR, Grimer RJ (1996) The outcome and functional results of diaphyseal endoprosthesis after tumour excision. J Bone Joint Surg [Br] 78:652–657 [PubMed]
- 2.Benevenia Semin Arthroplasty. 1994;5:76. [PubMed] [Google Scholar]
- 3.Bramwell J Clin Orthop. 1992;10:1579. doi: 10.1200/JCO.1992.10.10.1579. [DOI] [PubMed] [Google Scholar]
- 4.Cannon SR (1997) Massive prosthesis for malignant bone tumours of the limbs. J Bone Joint Surg [Br] 79:497–506 [DOI] [PubMed]
- 5.Clohisy DR, Mankin HJ (1994) Osteoarticular allografts for reconstruction after resection of a musculoskeletal tumour in the proximal end of the tibia. J Bone Joint Surg [Am] 76:549–554 [DOI] [PubMed]
- 6.Eckardt Orthop Clin North Am. 1991;22:149. [PubMed] [Google Scholar]
- 7.Eckardt JJ, Yang R, Ward WG, Kelly C, Eilber FR (1995) Endoprosthetic reconstruction for malignant bone tumours and nonmalignant tumourous conditions of bone. Advances in operative orthopaedics vol 3, Mosby, pp 61–83
- 8.EnnekingClin Orthop 198620493456859 [Google Scholar]
- 9.Enneking Clin Orthop. 1993;286:241. [PubMed] [Google Scholar]
- 10.Gottasauner-Wolf F, Kotz R, Knahr K, et al (1991) Rotationplasty for limb salvage in the treatment of malignant tumours at the knee: a follow-up of seventy patients. J Bone Joint Surg [Am] 73:1365–1375 [PubMed]
- 11.Grimer RJ, Carter SR, Pynsent (1997) The cost-effectiveness of limb salvage for bone tumours. J Bone Joint Surg [Br] 79:558–561 [DOI] [PubMed]
- 12.Grimer RJ, Carter SR, Sneath RS (1989) Endoprosthetic replacements of the proximal tibia. In: Langlais F, Tomeno B (eds) Limb salvage: major reconstructions in oncologic and non-tumoral conditions. Springer, Berlin, Heidelberg, New York, pp 285–292
- 13.Grimer RJ, Carter SR, Tillman RM, Sneath RS, Walker PS, Unwin PS, Shewell PC (1999) Endoprosthetic replacement of the proximal tibia. J Bone Joint Surg [Br] 81:488–494 [DOI] [PubMed]
- 14.Horowitz SM, Glasser DB, Lane Jm, Healey JH (1993) Prosthetic and extremity survivorship after limb salvage for sarcoma. How long do the reconstructions last? Clin Orthop 293:280–286 [PubMed]
- 15.Illyas Int Orthop. 2000;24:208. doi: 10.1007/s002640000158. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.KotzSemin Surg Oncol 19971334.9025180 [DOI] [Google Scholar]
- 17.Malawer Clin Orthop. 1989;239:231. [PubMed] [Google Scholar]
- 18.Mankin Orthop Clin North Am. 1987;18:275. [PubMed] [Google Scholar]
- 19.Otis JC, Lane JM, Kroll MA (1985) Energy cost during gait in osteosarcoma patients after resection and knee replacement and after above-knee amputation. J Bone Joint Surg [Am] 67:606–611 [PubMed]
- 20.Postma J Surg Oncol. 1992;51:47. doi: 10.1002/jso.2930510113. [DOI] [PubMed] [Google Scholar]
- 21.Rosun Prog Clin Biol Res. 1985;201:39. [PubMed] [Google Scholar]
- 22.Rougraff BT, Simon MA, Kneisl JS, Greenberg DB, Mankin HJ (1994) Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg [Am] 76:649–656 [DOI] [PubMed]
- 23.Sanjay Int Orthop. 1999;23:41. doi: 10.1007/s002640050301. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Unwin PS, Cannon SR, Grimer RJ, Kemp KBS, Sneath RS, Walker PS (1996) Aseptic loosening in cemented custom—made replacements for bone tumours of the lower limb. J Bone Joint Surg [Br] 78:5–13 [PubMed]
- 25.Yaw Orthop Clin North Am. 1991;22:133. [PubMed] [Google Scholar]
- 26.Zohman Clin Orthop. 1997;339:180. doi: 10.1097/00003086-199706000-00024. [DOI] [PubMed] [Google Scholar]