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. 2018 Sep 10;16(1):183.
doi: 10.1186/s12957-018-1486-3.

Uncemented, curved, short endoprosthesis stem for distal femoral reconstruction: early follow-up outcomes

Minxun Lu  1 , Jie Wang  1 , Cong Xiao  1   2 , Fan Tang  1 , Li Min  1 , Yong Zhou  1 , Wenli Zhang  1 , Chongqi Tu  3
Affiliations

Uncemented, curved, short endoprosthesis stem for distal femoral reconstruction: early follow-up outcomes

Minxun Lu et al. World J Surg Oncol. .

Abstract

Background: Uncemented endoprosthetic knee replacement has become a mainstream treatment for malignant tumours of the distal femur. Most femoral stems, however, are straight and therefore poorly fit the anteriorly bowed curvature of the femur. To address this issue, we used a short, curved, uncemented press-fit femoral stem and evaluated its short-term outcomes after reconstruction of the distal femur.

Methods: Forty-two patients underwent distal femur replacement using curved press-fit stem. To assess the interface, we measured the axial length of the press-fit area and the perpendicular distance of the radiolucent area between the stem and bone on digital images obtained using tomosynthesis with Shimadzu Metal Artefact Reduction Technology (T-SMART). Postoperative complications and oncological outcomes were monitored at each follow-up visit.

Results: Of the 42 patients enrolled in the study, two had cancer-related deaths and one had local tumour recurrence. The minimum follow-up time of the surviving patients was 24 months, with no incidence of aseptic loosening or mechanical failure of the prosthesis. The average effective contact length between the press-fit stem and bone was 74.0 mm, with nearly undetectable radiolucent gaps between the implant and the bone on medial-lateral and anteroposterior views.

Conclusions: Over the short term, uncemented, curved, short stem provides a stable bone-prosthesis interface without any aseptic loosening.

Keywords: Curvature; Distal femur; Short; Stem; Uncemented.

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Conflict of interest statement

Ethics approval and consent to participate

This retrospective study was approved by the ethical committee of West China Hospital, Sichuan University (Chengdu, China), and performed in accordance with the ethical standards of the 1964 Declaration of Helsinki. Written informed consent to participate in this study was obtained from all patients.

Consent for publication

All patients gave permission to publish the images.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Design specification and schematic cross sections of the curved femoral stem
Fig. 2
Fig. 2
The flexible reamer we used
Fig. 3
Fig. 3
A case of reconstruction of the distal femur following distal resection of 73% of the length of the femur. a Postero-anterior radiograph of the entire femur. b, c Postero-anterior and lateral radiographic views of the region of stem insertion of the femur. d, e Postero-anterior and lateral T-SMART views of the stem insertion region of the femur
Fig. 4
Fig. 4
A case of reconstruction of the distal femur following a distal resection of 54% of the length of the femur. a Postero-anterior radiograph of the entire femur. b, c Postero-anterior and lateral radiographic views of the region of stem insertion of the femur. d, e Postero-anterior and lateral T-SMART views of the stem insertion region of the femur
Fig. 5
Fig. 5
A case of reconstruction of the distal femur following a distal resection of 26% of the length of the femur. a Postero-anterior radiograph of the entire femur. b, c Postero-anterior and lateral radiographic views of the region of stem insertion of the femur. d, e Postero-anterior and lateral T-SMART views of the stem insertion region of the femur
Fig. 6
Fig. 6
A typical case of bone ingrowth is shown
See this image and copyright information in PMC

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