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Comparison of Proximal Tibial Endoprosthetic and Allograft-Prosthetic Reconstruction
Marisa N Ulrich1, Katherine E Mallett1, Samuel E Broida1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Introduction:
The proximal tibia is a common location for bone tumors. Two contemporary reconstruction techniques for limb salvage are endoprosthetic replacement (EPR) and allograft-prosthesis composite (APC). This study aimed to compare the long-term oncologic and functional outcomes of EPR and APC reconstructions.
Methods:
Thirty-eight (19 APC and 19 EPR) patients underwent oncologic proximal tibia resection and reconstruction were reviewed. Patients undergoing APC reconstruction were younger than the EPR group (31 vs. 44 years, p = 0.049), and patients in the EPR group were more likely to have a diagnosis of metastatic disease (32% vs. 0%, p = 0.019).
Results:
For all patients, the 10-year disease-specific survival was 63%. With death a competing risk, there was no difference in the 10-year cumulative risk of failure (41% vs. 26%, p = 0.171) or amputation (11% vs. 19%, p = 0.690) between APC or EPR. There was no difference comparing EPR to APC in the proportion of patients with an extensor lag > 10° (42% vs. 26%, p = 0.495) or 10-year knee society scores (85 vs. 85, p = 0.710).
Conclusion:
EPR and APC have a similar complication profile and functional outcomes following proximal tibial resection and reconstruction.
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