Related Experiment Videos
Extendible replacements of the proximal tibia for bone tumours
R J Grimer1, M Belthur, S R Carter
1Royal Orthopaedic Hospital Oncology Service, Birmingham, England.
The Journal of Bone and Joint Surgery. British Volume
|February 7, 2001
Summary
Extendible prostheses for pediatric proximal tibia bone tumors present challenges. While 11 children retained functioning limbs, complications like infection and aseptic loosening were frequent, indicating an experimental status for this limb salvage technique.
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Biomedical Engineering
Background:
- Limb salvage surgery is standard for primary bone tumors.
- The proximal tibia is a common tumor site, posing reconstruction challenges, especially in pediatric cases.
- Extendible prostheses offer a solution for limb length preservation in growing children.
Purpose of the Study:
- To evaluate the outcomes of extendible proximal tibial replacements in pediatric patients.
- To identify complications and functional results associated with this limb salvage technique.
- To compare traditional methods with newer, minimally invasive approaches.
Main Methods:
- Review of 20 pediatric patients with extendible proximal tibial replacements.
- Minimum follow-up of five years.
- Analysis of complications, functional scores (Musculoskeletal Tumor Society), and need for revision surgery or amputation.
Main Results:
- Five patients died from disease; four required amputation due to complications.
- Infection occurred in seven patients, often linked to the lengthening process.
- Aseptic loosening was common in younger patients; only two avoided major complications.
- Eleven children achieved a functioning limb with a mean MSTS score of 83%.
Conclusions:
- Extendible proximal tibial prostheses in children are associated with significant complication rates.
- While functional limbs can be achieved, the procedure remains experimental due to risks.
- A shift towards simpler, minimally invasive techniques is underway to mitigate complications.