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[Alloarthroplasty versus above-knee amputation].

K Daniilidis1, E Jakubowitz, C Stukenborg-Colsman

  • 1Orthopädische Klinik, Medizinische Hochschule Hannover im Annastift, Hannover, Deutschland, Kiriakos.Daniilidis@ddh-gruppe.de.

Der Orthopade
|April 21, 2015
PubMed
Summary
This summary is machine-generated.

A patient with a tumor endoprosthesis underwent knee disarticulation, preserving the femoral component. This innovative approach resulted in a functional gait with an interim prosthesis, offering a viable limb salvage option for complex cases.

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Area of Science:

  • Orthopedic surgery
  • Limb reconstruction
  • Prosthetic rehabilitation

Background:

  • A 38-year-old patient with a history of Ewing sarcoma and multiple revision surgeries experienced persistent pain due to aseptic loosening of a tumor endoprosthesis.
  • The patient opted for amputation over further limb-sparing surgeries due to prolonged suffering.

Observation:

  • Traditional above-knee amputation posed risks of a short femoral residual limb, potentially complicating exoprosthetic fitting and function.
  • The patient's preference for amputation, coupled with the challenges of conventional procedures, necessitated an alternative surgical strategy.

Findings:

  • A novel knee disarticulation technique was performed, decoupling the tibial component and preserving the femoral component of the tumor endoprosthesis.
  • Postoperative gait analysis revealed a harmonious pattern with a mechanical interim prosthesis, indicating good functional outcomes.
  • Sagittal joint angles were comparable to those observed in conventional knee disarticulations.

Implications:

  • This case demonstrates the feasibility and effectiveness of knee disarticulation within a tumor arthroplasty, preserving the femoral component.
  • The technique offers a viable limb salvage option, potentially improving functional outcomes and prosthetic integration in complex orthopedic cases.
  • This approach may be a valuable alternative to conventional amputation when facing challenges with revision arthroplasty and limb salvage.