Survival of Proximal Tibial Endoprostheses Using Compressive Osseointegration: A Multi-Institution Retrospective...

Area of Science:

• Orthopedic oncology
• Biomaterials science
• Surgical reconstruction

Background:

• The Compress (CPS) implant aims to improve osseointegration and reduce aseptic loosening.
• Previous studies on CPS implants in the proximal tibia had limitations in patient cohort size and follow-up duration.

Purpose of the Study:

• To evaluate the cumulative incidence of mechanical failure for the CPS implant in proximal tibia reconstructions for oncologic indications.
• To assess failure types, rates, and unplanned reoperations associated with the CPS implant.

Main Methods:

• Multi-institution retrospective analysis of patients undergoing proximal tibia reconstruction with a CPS endoprosthesis for primary bone tumors.
• Minimum 2-year follow-up with Kaplan-Meier survival analysis and Cox proportional hazard models.

Main Results:

• Fifty-three patients were included with a median follow-up of 7.5 years.
• Five- and 10-year implant survivorship was 89.8% and 89.8% respectively.
• Twenty-one unplanned reoperations occurred, with 5- and 10-year survival probabilities of 68.9% and 52.5%.

Conclusions:

• Compressive osseointegration provides a durable method for anchoring large endoprostheses in the proximal tibia.
• While the CPS implant shows promise, reoperation rates highlight areas for improvement in long-term mechanical durability.