Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Jun;129(8):1568-1576.
doi: 10.1002/jso.27670. Epub 2024 May 27.

Extended distal femur resection: Megaprosthesis with telescopic bone allograft augmentation versus total femur prosthesis

Alessandro Bruschi  1   2 , Luca Cevolani  1 , Andrea Minerba  1   2 , Davide Conversano  2 , Luigi Falzetti  1   2 , Stefano Pasini  1   2 , Davide M Donati  1   2
Affiliations
Comparative Study

Extended distal femur resection: Megaprosthesis with telescopic bone allograft augmentation versus total femur prosthesis

Alessandro Bruschi et al. J Surg Oncol. 2024 Jun.

Abstract

Background and objective: Oncological distal femur resections can leave a proximal femur too short to host a stem. Reconstructive techniques are then challenging. The purpose of the study is to compare implant survival, complication rate and MSTS of two different options.

Methods: We retrospectively divided 33 patients with primary bone tumours of distal femur in Group 1 (16 patients reconstructed with knee megaprosthesis with proximal bone augmentation, APC) and Group 2 (17 patients reconstructed with total femur prosthesis, TFP). Less than 12 cm of remaining proximal femur were planned for all resections.

Results: MSTS score at 2 years is 25 ± 5 for Group 1 and 19 ± 7 for Group 2 (confidence interval [C.I.] 95%, p = 0.02). At 5 years it is 27 ± 2 for Group 1 and 22 ± 6 for Group 2 (C.I. 95%, p = 0.047). Failure and complication rates are lower for Group 1, but no statistical significance was reached. In APC reconstruction, union at the host-allograft junction was achieved in 16 out of 16 patients using the telescopic bone augmentation technique.

Conclusions: APC provides higher functional results compared to TFP after extended distal femur resection. In APC reconstruction, telescopic augmentation is excellent for achieving union at the host-allograft junction.

Keywords: allograft prosthetic composite; bone allograft augment; knee megaprosthesis; malignant bone tumour; telescopic technique; total femur prosthesis.

PubMed Disclaimer

References

REFERENCES

    1. Dieckmann R, Henrichs M‐P, Gosheger G, Höll S, Hardes J, Streitbürger A. Short‐stem reconstruction for megaendoprostheses in case of an ultrashort proximal femur. BMC Musculoskelet Disord. 2014;15:190. doi:10.1186/1471-2474-15-190
    1. Mankin HJ, Hornicek FJ, Harris M. Total femur replacement procedures in tumor treatment. Clin Orthop Relat Res. 2005;438:60‐64. doi:10.1097/00003086-200509000-00012
    1. Moon BS, Gilbert NF, Cannon CP, Lin PP, Lewis VO. Distal femur allograft prosthetic composite reconstruction for short proximal femur segments following tumor resection. Adv Orthop. 2013;2013:1‐5. doi:10.1155/2013/397456
    1. Pedtke AC, Wustrack RL, Fang AS, Grimer RJ, O'Donnell RJ. Aseptic failure: how does the compress® implant compare to cemented stems? Clin Orthop Relat Res. 2012;470:735‐742. doi:10.1007/s11999-011-2159-5
    1. Healey JH, Abdeen A, Morris CD, Athanasian EA, Boland PJ. Telescope allograft method to reconstitute the diaphysis in limb salvage surgery. Clin Orthop Relat Res. 2009;467:1813‐1819. doi:10.1007/s11999-008-0548-1

Publication types

LinkOut - more resources