Risk-Stratified Predictive Analysis of Docking Site Outcomes in Lower Extremity Bone Transport: Identifying High-Risk...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Regenerative Medicine

Background:

• Reconstructing extensive bone loss in limbs presents significant surgical challenges.
• Historically, large bone defects often necessitated amputation due to limited treatment options.
• Modern techniques like Masquelet and distraction osteogenesis offer alternatives but face challenges with bone fusion.

Purpose of the Study:

• To identify predictive factors for the necessity of a docking site procedure in limb reconstruction.
• To analyze variables influencing the need for secondary surgery following bone transport.
• To improve treatment planning for complex lower extremity bone defects.

Main Methods:

• Retrospective analysis of 93 patients with lower extremity bone defects (2013-2023).
• Focus on 39 patients undergoing segmental bone transport for predictive model analysis.
• Logistic regression, ROC analysis, and ANOVA used to identify predictors for docking site procedures.

Main Results:

• A docking site procedure was required in 64.1% of segmental transport patients.
• Significant predictors identified: patient age, vascular injury, transport duration, and transport speed.
• Transport speed (AUC=0.931) and duration (AUC=0.911) showed strong predictive ability for docking site procedure necessity.

Conclusions:

• Transport duration and speed are valuable predictive factors for docking site procedures in limb reconstruction.
• A transport duration exceeding 290.5 days significantly elevates the risk of needing a docking site procedure.
• Findings support optimizing treatment strategies and enhancing limb preservation outcomes.