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Intercalary Diaphyseal Endoprosthetic Reconstruction
Timothy A Damron1, Anjali Malhotra
1From the Department of Orthopedic Surgery, SUNY Upstate Medical University (Dr. Damron), and the Norton College of Medicine, SUNY Upstate Medical University (Malhotra).
Summary
Intercalary endoprosthetic devices offer diaphyseal reconstruction for bone tumors and metastases. Aseptic loosening is a primary failure risk, necessitating careful patient selection and consideration of alternative reconstructive options.
Area of Science:
- Orthopedic Surgery
- Oncology
- Biomedical Engineering
Background:
- Intercalary endoprostheses are used for diaphyseal reconstruction in primary bone tumors and skeletal metastases.
- These devices are often indicated for pathological fractures or failed internal fixation, requiring sufficient proximal and distal bone stock.
Purpose of the Study:
- To review the various designs, indications, contraindications, and alternative reconstructive options for intercalary endoprosthetic devices.
- To discuss the biomechanics, functional outcomes, and complication profiles associated with these implants.
Main Methods:
- Literature review of intercalary endoprosthetic devices for diaphyseal reconstruction.
- Analysis of reported functional results and complication rates, including aseptic loosening.
- Comparison with alternative reconstructive methods such as autografts, allografts, and cement augmentation.
Main Results:
- Intercalary endoprostheses provide acceptable functional results but carry risks, with aseptic loosening being a common failure mode.
- These devices are frequently utilized in cases of segmental bone destruction, particularly in the upper extremity, and in patients with metastatic bone disease or myeloma.
- Success is often observed at short follow-up periods.
Conclusions:
- Intercalary endoprosthetic reconstruction is a viable option for diaphyseal bone defects but requires careful consideration of risks and patient selection.
- Aseptic loosening is a significant concern, and alternative surgical strategies should be considered.
- Further research into long-term outcomes and novel implant designs may be warranted.
