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Custom megaprosthetic replacement for proximal tibial tumours
Mayil Vahanan Natarajan1, A Sivaseelam, G Rajkumar
1Department of Orthopaedics and Traumatology, Madras Medical College and Research Institute, Government General Hospital, 600 003, Chennai, India. drmayil@bonetumour.org
International Orthopaedics
|July 3, 2003
Summary
Proximal tibial replacement using endoprosthetics offers good functional outcomes for patients with bone tumors. Limb survival rates are favorable, though complications like infection and fracture require attention.
Area of Science:
- Orthopedic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Bone tumors, particularly osteosarcoma, frequently affect the proximal tibia.
- Surgical resection with limb reconstruction is a common treatment modality.
- Endoprosthetic replacement offers a limb salvage option for extensive bone resections.
Purpose of the Study:
- To evaluate the functional outcomes and survival rates of proximal tibial replacement using endoprosthetics.
- To identify the most common complications associated with this procedure.
- To assess the long-term limb salvage efficacy in patients with bone tumors.
Main Methods:
- Retrospective analysis of 133 patients undergoing resection and endoprosthetic proximal tibial replacement between 1988 and 2000.
- Data collection included patient demographics, tumor type, functional outcomes, complications, and survival status.
- Follow-up averaged 59.4 months.
Main Results:
- Osteosarcoma was the most frequent diagnosis in a cohort with a mean age of 22.3 years.
- Excellent or good functional results were achieved in 99 patients (99/133).
- 102 patients showed no evidence of disease, while 24 died due to their condition. Infection (30/133) was the most common complication, followed by periprosthetic fracture (22/133) and aseptic loosening (18/133). The 5-year limb survival rate was 85.5%.
Conclusions:
- Endoprosthetic proximal tibial replacement provides a viable limb salvage option for patients with bone tumors, yielding good functional results.
- While limb survival rates are encouraging, careful management of complications such as infection and periprosthetic fractures is crucial for optimizing patient outcomes.
- This reconstructive technique demonstrates significant efficacy in managing proximal tibial bone defects, contributing to improved quality of life and oncological control.