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. 2003;27(3):160-3.
doi: 10.1007/s00264-003-0429-x. Epub 2003 Feb 8.

Risk of amputation following limb salvage surgery with endoprosthetic replacement, in a consecutive series of 1261 patients

L M Jeys  1 , R J Grimer, S R Carter, R M Tillman
Affiliations

Risk of amputation following limb salvage surgery with endoprosthetic replacement, in a consecutive series of 1261 patients

L M Jeys et al. Int Orthop. 2003.

Abstract
in English, French

Endoprosthetic replacements are commonly used for limb salvage following surgical excision of bone tumours. Advantages include initial reliability, rapid restoration of function and their ready availability. Potential long-term problems include loosening, infection and mechanical failure. Increasing problems may lead to the necessity for amputation; this paper assesses that risk. A total of 1,261 patients have undergone endoprosthetic replacements in our centre in the past 34 years, with a total of 6,507 patient years of follow up. A total of 112 patients have had subsequent amputation. The reasons for amputation were local recurrence in 71, infection in 38, mechanical failure in two and chronic pain in one. The proximal tibia had the greatest risk of amputation (n=38/245). The time to amputation varied from 2 days to 16 years, with a mean of 31 months. The risk of amputation decreased with time, although 10% took place after more than 5 years.

Les remplacements prothétiques sont couramment utilisés pour la réhabilitation d'un membre après excision chirurgicale d'une tumeur osseuse. Les avantages incluent fiabilité initiale et restauration rapide de la fonction. Les ennuis potentiels à long terme sont le descellement, l'infection et la faillite mécanique. Les problèmes croissants peuvent mener à la nécessité d'une amputation; ce travail étudie ce risque. Un total de 1261 malades a subi des remplacements prothétiques dans les 34 années passées, avec un total de 6507 années- patients de suivi. 112 malades ont eu une amputation dont les raisons étaient: récidive locale pour 71, infection pour 38, échec mécanique pour 2 et douleur chronique pour 1 cas. Le tibia proximal avait le plus grand risque d'amputation (n=38/245). Le délai d'amputation variait de 2 jours à 16 années, avec une moyenne de 31 mois. Le risque d'amputation diminue avec le temps, bien que 10% des amputations aient eu lieu après plus de 5 années.

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Figures

Fig. 1.
Fig. 1.
Survivorship of all limbs following endoprosthetic replacement without amputation, using Kaplan-Meier analysis (95% confidence level)
Fig. 2.
Fig. 2.
Survivorship of limbs following endoprosthetic replacements without amputations comparing patients with and without local recurrence, using Kaplan-Meier analysis (95% confidence level)
Fig. 3.
Fig. 3.
Distribution of time to amputation
See this image and copyright information in PMC

References

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