Limits...
Cemented allograft-prosthesis composite reconstruction for the proximal femur tumor.

Min L, Tang F, Duan H, Zhou Y, Zhang WL, Shi R, Tu CQ - Onco Targets Ther (2015)

Bottom Line: Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%).Eight (32.0%) hips had resorption.There were no cases of recurrence, but metastasis was found in two hips.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

ABSTRACT

Introduction: Cemented allograft-prosthesis composite (APC) reconstruction is one option following resection of the proximal femur tumor. However, rare studies have focused on the indications and complications. The goal of the present study was to (1) ascertain the indications for cemented APC arthroplasty in the proximal femur; (2) identify the detailed perioperative management; and (3) illustrate our experiences to avoid the complications of cemented APC.

Materials and methods: A total 28 patients who underwent cemented APC reconstruction of the proximal femur after tumor resection were retrospectively evaluated at a median follow-up of 56 months. Clinical records and radiographs were reviewed to evaluate patients' outcome.

Results: In our series, excluding three cases of death that had a short follow-up period, union occurred in 22 (88.0%) patients (range 9-18 months). Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%). Eight (32.0%) hips had resorption. There were two (8.0%) hips that were observed to have asymptomatic wear of the acetabulum. The average Musculoskeletal Tumor Society (MSTS) score was 26.5 points. The average Harris Hip Score (HHS) score was 80.6 points. There were no cases of recurrence, but metastasis was found in two hips.

Conclusions: Mastering indications, perioperative management, and complication prevention are all very important in the APC reconstruction after resection of the proximal femur.

No MeSH data available.


Related in: MedlinePlus

The radiograph shows a 3-year postoperative AP of a cemented allograft prosthesis composite for an osteosarcoma.Note: The black arrow indicates the allograft host–bone nonunion because of the cement in the junction.Abbreviation: AP, anterior-posterior X-ray.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4556043&req=5

f7-ott-8-2261: The radiograph shows a 3-year postoperative AP of a cemented allograft prosthesis composite for an osteosarcoma.Note: The black arrow indicates the allograft host–bone nonunion because of the cement in the junction.Abbreviation: AP, anterior-posterior X-ray.

Mentions: We divided complications into intraoperative and postoperative categories. During surgery, there was no neurovascular injury, fracture, fat embolism, coagulopathy, or pulmonary edema. In the late phase, however, there were many complications, including nonunion, nonunion of the greater trochanter, resorption, progressive wear of the acetabulum, and periprosthetic fracture. Nonunion was one of the most serious and worrisome complications: three hips (12.0%) had nonunion of the bone–allograft junction (Figure 7), nine hips (36.0%) had delayed union, and six hips (50.0%) had nonunion in the greater trochanter. As mentioned earlier, eight hips (32.0%) had resorption of the allograft, and two hips (8.0%) had progressive wear of the acetabulum in which one hip had periprosthetic fracture – only one of the hips with periprosthetic fracture and progressive wear of the acetabulum underwent additional revision surgery, at 10 years after the original revision (Figures 5–7). Up to now, in our series, there has been no infection, dislocation, or chronic allergic reaction cases.


Cemented allograft-prosthesis composite reconstruction for the proximal femur tumor.

Min L, Tang F, Duan H, Zhou Y, Zhang WL, Shi R, Tu CQ - Onco Targets Ther (2015)

The radiograph shows a 3-year postoperative AP of a cemented allograft prosthesis composite for an osteosarcoma.Note: The black arrow indicates the allograft host–bone nonunion because of the cement in the junction.Abbreviation: AP, anterior-posterior X-ray.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556043&req=5

f7-ott-8-2261: The radiograph shows a 3-year postoperative AP of a cemented allograft prosthesis composite for an osteosarcoma.Note: The black arrow indicates the allograft host–bone nonunion because of the cement in the junction.Abbreviation: AP, anterior-posterior X-ray.
Mentions: We divided complications into intraoperative and postoperative categories. During surgery, there was no neurovascular injury, fracture, fat embolism, coagulopathy, or pulmonary edema. In the late phase, however, there were many complications, including nonunion, nonunion of the greater trochanter, resorption, progressive wear of the acetabulum, and periprosthetic fracture. Nonunion was one of the most serious and worrisome complications: three hips (12.0%) had nonunion of the bone–allograft junction (Figure 7), nine hips (36.0%) had delayed union, and six hips (50.0%) had nonunion in the greater trochanter. As mentioned earlier, eight hips (32.0%) had resorption of the allograft, and two hips (8.0%) had progressive wear of the acetabulum in which one hip had periprosthetic fracture – only one of the hips with periprosthetic fracture and progressive wear of the acetabulum underwent additional revision surgery, at 10 years after the original revision (Figures 5–7). Up to now, in our series, there has been no infection, dislocation, or chronic allergic reaction cases.

Bottom Line: Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%).Eight (32.0%) hips had resorption.There were no cases of recurrence, but metastasis was found in two hips.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

ABSTRACT

Introduction: Cemented allograft-prosthesis composite (APC) reconstruction is one option following resection of the proximal femur tumor. However, rare studies have focused on the indications and complications. The goal of the present study was to (1) ascertain the indications for cemented APC arthroplasty in the proximal femur; (2) identify the detailed perioperative management; and (3) illustrate our experiences to avoid the complications of cemented APC.

Materials and methods: A total 28 patients who underwent cemented APC reconstruction of the proximal femur after tumor resection were retrospectively evaluated at a median follow-up of 56 months. Clinical records and radiographs were reviewed to evaluate patients' outcome.

Results: In our series, excluding three cases of death that had a short follow-up period, union occurred in 22 (88.0%) patients (range 9-18 months). Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%). Eight (32.0%) hips had resorption. There were two (8.0%) hips that were observed to have asymptomatic wear of the acetabulum. The average Musculoskeletal Tumor Society (MSTS) score was 26.5 points. The average Harris Hip Score (HHS) score was 80.6 points. There were no cases of recurrence, but metastasis was found in two hips.

Conclusions: Mastering indications, perioperative management, and complication prevention are all very important in the APC reconstruction after resection of the proximal femur.

No MeSH data available.


Related in: MedlinePlus