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. 2005 Feb;29(1):25-9.
doi: 10.1007/s00264-004-0614-6. Epub 2005 Jan 5.

Endoprosthetic replacement of diaphyseal bone defects. Long-term results

E Aldlyami  1 , A Abudu, R J Grimer, S R Carter, R M Tillman
Affiliations

Endoprosthetic replacement of diaphyseal bone defects. Long-term results

E Aldlyami et al. Int Orthop. 2005 Feb.

Abstract
in English, French

We retrospectively studied 35 patients who underwent endoprosthetic reconstruction of diaphyseal bone defects after excision of primary sarcomas. The patients were treated between February 1979 and May 1999 and had more than 5 years follow-up. There were 22 males and 13 females and the median age at diagnosis was 29 (8-75) years. The bone defect measured a mean of 19 (10-27.6) cm. There were 29 femoral reconstructions, three tibial and three humeral. Cumulative overall survival for all patients was 65% at 10 years. Cumulative overall survival for prosthetic reconstruction, using revision surgery as an end point, was 63% at 10 years. Cumulative risk of failure of reconstruction, including infection, fracture, aseptic loosening, local recurrence and amputation, was 60% at 10 years. Tibial and humeral reconstructions fared less well than femoral. Endoprosthetic replacement is a useful method of reconstructing long intercalary defects, especially if situated in the femur.

Nous avons étudié rétrospectivement 35 malades qui ont subi une reconstruction endoprothétique après excision diaphysaire d’un sarcome primaire. Les malades ont été traités entre février 1979 et mai 1999 et avaient plus de 5 ans de suivi. Il y avait 22 hommes et 13 femmes et l’âge médian au diagnostic était de 29 (8–75) ans. Le défaut osseux mesurait en moyenne 19 (10–27.6) cm. Il y avait 29 reconstructions fémorales, trois tibiales et trois humérales. La survie totale cumulative pour tous les malades était 65% à 10 ans. La survie totale cumulative pour la reconstruction prothétique, en utilisant la chirurgie de révision comme élément final, était de 63% à 10 ans. Le risque cumulatif d’échec en incluant: l’infection, la fracture, le démontage aseptique, la récidive locale et l’amputation étaient de 60% à 10 ans. Les reconstructions tibiales et humérales sont allées moins bien que les fémorales. Le remplacement endoprothétique est une méthode utile pour reconstruire de longues pertes de substance intercalaires, surtout si elles sont situées sur le fémur.

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Figures

Fig. 1
Fig. 1
Diaphyseal endoprosthesis showing how it is manufactured in two parts and the intramedullary stems are customised to fit the host bone.
Fig. 2
Fig. 2
Survivorship of the endoprostheses using revision or further surgery for any reason as the endpoint. Dotted lines show the 95% confidence limits
Fig. 3
Fig. 3
Fractured endoprostheses of the left femur.
Fig. 4
Fig. 4
Left femur 6 months after revision surgery.
See this image and copyright information in PMC

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