Failure rates and functional results for intercalary femur reconstructions after tumour resection

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Albergo , J I , Gaston , C L , Farfalli , G , Laitinen , M , Parry , M C , Ayerza , MA , Risk , M , Jeys , L M & Aponte-Tinao , L 2020 , ' Failure rates and functional results for intercalary femur reconstructions after tumour resection ' , Musculoskeletal surgery , vol. 104 , no. 1 , pp. 59-65 . https://doi.org/10.1007/s12306-019-00595-1

Title: Failure rates and functional results for intercalary femur reconstructions after tumour resection
Author: Albergo, J. I.; Gaston, Czar L.; Farfalli, German; Laitinen, M.; Parry, Michael C; Ayerza, MA; Risk, M; Jeys, Lee M; Aponte-Tinao, Luis
Contributor: University of Helsinki, HUS Musculoskeletal and Plastic Surgery
Date: 2020-04
Language: eng
Number of pages: 7
Belongs to series: Musculoskeletal surgery
ISSN: 2035-5106
URI: http://hdl.handle.net/10138/329524
Abstract: Purpose To compare the results for patients treated with intercalary endoprosthetic replacement (EPR) or intercalary allograft reconstruction for diaphyseal tumours of the femur in terms of: (1) reconstruction failure rates; (2) cause of failure; (3) risk of amputation of the limb; and (4) functional result. Methods Patients with bone sarcomas of the femoral diaphysis, treated with en bloc resection and reconstructed with an intercalary EPR or allograft, were reviewed. A total of 107 patients were included in the study (36 EPR and 71 intercalary allograft reconstruction). No differences were found between the two groups in terms of follow-up, age, gender and the use of adjuvant chemotherapy. Results The probability of failure for intercalary EPR was 36% at 5 years and 22% for allograft at 5 years (p = 0.26). Mechanical failures were the most prevalent in both types of reconstruction. Aseptic loosening and implant fracture are the main cause in the EPR group. For intercalary allograft reconstructions, fracture followed by nonunion was the most common complication. Ten-year risk of amputation after failure for both reconstructions was 3%. There were no differences between the groups in terms of the mean Musculoskeletal Tumor Society score (27.4, range 16–30 vs. 27.6, range 17–30). Conclusions We have demonstrated similar failure rates for both reconstructions. In both techniques, mechanical failure was the most common complication with a low rate of limb amputation and good functional results. Level of evidence Level III, therapeutic study.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
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