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Multicenter Study
. 2014 Mar;472(3):822-9.
doi: 10.1007/s11999-013-2885-y.

A dual-center review of compressive osseointegration for fixation of massive endoprosthetics: 2- to 9-year followup

George T Calvert  1 , Judd E Cummings, Austin J Bowles, Kevin B Jones, L Daniel Wurtz, R Lor Randall
Affiliations
Multicenter Study

A dual-center review of compressive osseointegration for fixation of massive endoprosthetics: 2- to 9-year followup

George T Calvert et al. Clin Orthop Relat Res. 2014 Mar.

Erratum in

  • Clin Orthop Relat Res. 2013 Jun;471(6):2041

Abstract

Background: Aseptic failure of massive endoprostheses used in the reconstruction of major skeletal defects remains a major clinical problem. Fixation using compressive osseointegration was developed as an alternative to cemented and traditional press-fit fixation in an effort to decrease aseptic failure rates.

Questions/purposes: The purpose of this study was to answer the following questions: (1) What is the survivorship of this technique at minimum 2-year followup? (2) Were patient demographic variables (age, sex) or anatomic location associated with implant failure? (3) Were there any prosthesis-related variables (eg, spindle size) associated with failure? (4) Was there a discernible learning curve associated with the use of the new device as defined by a difference in failure rate early in the series versus later on?

Methods: The first 50 cases using compressive osseointegration fixation from two tertiary referral centers were retrospectively studied. Rates of component removal for any reason and for aseptic failure were calculated. Demographic, surgical, and oncologic factors were analyzed using regression analysis to assess for association with implant failure. Minimum followup was 2 years with a mean of 66 months. Median age at the time of surgery was 14.5 years.

Results: A total of 15 (30%) implants were removed for any reason. Of these revisions, seven (14%) were the result of aseptic failure. Five of the seven aseptic failures occurred at less than 1 year (average, 8.3 months), and none occurred beyond 17 months. With the limited numbers available, no demographic, surgical, or prosthesis-related factors correlated with failure.

Conclusions: Most aseptic failures of compressive osseointegration occurred early. Longer followup is needed to determine if this technique is superior to other forms of fixation.

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Figures

Fig. 1A–C
Fig. 1A–C
(A) Intraoperative photograph of Compress® implantation is shown. (B) This is an intraoperative photograph of distal femoral replacement attachment to the Compress® device. (C) Two-year postoperative radiographs show the osseointegrated device.
Fig. 2A–B
Fig. 2A–B
(A) Kaplan-Meier survival curves for all-cause failure is shown. (B) This is Kaplan-Meier survival curves for aseptic failure.
See this image and copyright information in PMC

References

    1. Avedian RS, Goldsby RE, Kramer MJ, O’Donnell RJ. Effect of chemotherapy on initial compressive osseointegration of tumor endoprostheses. Clini Orthop Relat Res. 2007;459:48–53. doi: 10.1097/BLO.0b013e3180514c66. - DOI - PubMed
    1. Bhangu AA, Kramer MJ, Grimer RJ, O’Donnell RJ. Early distal femoral endoprosthetic survival: cemented stems versus the Compress implant. Int Orthop. 2006;30:465–472. doi: 10.1007/s00264-006-0186-8. - DOI - PMC - PubMed
    1. Bini SA, Johnston JO, Martin DL. Compliant prestress fixation in tumor prostheses: interface retrieval data. Orthopedics. 2000;23:707–711. - PubMed
    1. Cristofolini L, Bini S, Toni A. In vitro testing of a novel limb salvage prosthesis for the distal femur. Clin Biomech (Bristol, Avon). 1998;13:608–615. doi: 10.1016/S0268-0033(98)00024-2. - DOI - PubMed
    1. Donati D, Colangeli M, Colangeli S, Di Bella C, Mercuri M. Allograft-prosthetic composite in the proximal tibia after bone tumor resection. Clin Orthop Relat Res. 2008;466:459–465. doi: 10.1007/s11999-007-0055-9. - DOI - PMC - PubMed

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