Limb salvage for proximal tibial tumours using a modular prosthesis

Area of Science:

• Orthopedic Surgery
• Oncology
• Biomedical Engineering

Background:

• Proximal tibial tumors require complex surgical management.
• Limb salvage surgery aims to preserve function after tumor resection.
• Modular prostheses offer reconstructive options for large bone defects.

Purpose of the Study:

• To evaluate the early outcomes of proximal tibial tumor resection and reconstruction with modular prostheses.
• To identify the complication rates associated with this surgical approach.

Main Methods:

• Retrospective review of 15 patients undergoing wide resection of proximal tibial tumors.
• Reconstruction using modular prostheses.
• Assessment of mechanical failures, neurological complications, vascular injuries, infections, and functional outcomes (Musculo-Skeletal Tumour Society score).

Main Results:

• No mechanical failures were observed over an average 3.5-year follow-up.
• High complication rates included 5 peroneal nerve palsies, 1 sciatic nerve palsy, 1 vascular injury requiring amputation, and 2 deep prosthetic infections.
• Other complications included skin necroses and a periprosthetic fracture.
• The mean Musculo-Skeletal Tumour Society score was 18.3/30 for patients with prosthesis in situ.

Conclusions:

• Limb salvage surgery for proximal tibial tumors using modular prostheses is associated with a high early complication rate.
• Despite modern implants, significant neurological, infectious, and mechanical complications can occur.
• Careful patient selection and surgical planning are crucial to mitigate risks.