Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\27106130
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Orthop+Relat+Res
2016 ; 474
(7
): 1714-23
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
How Often Does Spindle Failure Occur in Compressive Osseointegration
Endoprostheses for Oncologic Reconstruction?
#MMPMID27106130
Clin Orthop Relat Res
2016[Jul]; 474
(7
): 1714-23
PMID27106130
show ga
BACKGROUND: Compressive osseointegration is a promising modality for limb salvage
in distal femoral oncologic tumors. However, few studies have explored short-term
survival rates in a large patient cohort of distal femur compressive
endoprostheses or highlighted the risk factors for spindle failures.
QUESTIONS/PURPOSES: We asked: (1) What is the frequency of compressive
osseointegration spindle failure in distal femoral reconstructions? (2) What are
the characteristics of rotational failure cases with distal femur compressive
osseointegration endoprostheses? (3) What are the risk factors for mechanical and
rotational failure of distal femur compressive osseointegration implantation? (4)
What are other modalities of failure or causes of revision surgery, which affect
patients undergoing distal femur compressive osseointegration implantation for
oncologic reconstruction? METHODS: Between 1996 and 2013, 127 distal femoral
reconstructions with the Compress(®) prosthesis were performed in 121 patients.
During that time, 116 Compress(®) prostheses were implanted for aggressive
primary tumors of the distal femur and/or failure of previous oncologic
reconstruction. This approach represented approximately 91% of the distal femoral
reconstructions performed during that time. Of the patients with prostheses
implanted, four patients (four of 116, 3%) had died, and 37 (37 of 116, 32%) were
lost to followup before 24 months. The median followup was 84 months (range,
24-198 months), and 71 patients (66% of all patients) were seen within the last 3
years. A retrospective chart review was performed to determine failure modality
as defined by radiographs, clinical history, and intraoperative findings. Risk
factors including age, sex, BMI, resection length, and perioperative chemotherapy
were analyzed to determine effect on spindle and rotational failure rates.
Survival analysis was determined using the Kaplan-Meier estimator. Differences in
survival between groups were analyzed using the log rank test. Risk factors were
determined using Cox proportional hazard modeling. RESULTS: Spindle survival at 5
and 10 years was 91% (95% CI, 82%-95%). Survival rates from rotational failure at
5 and 10 years were 92% (95% CI, 83%-96%); the majority of failures occurred
within the first 2 years postoperatively and were the result of a twisting
mechanism of injury. With the numbers available, none of the potential risk
factors examined were associated with mechanical failure. The 5-year and 10-year
all-cause revision-free survival rates were 57% (95% CI, 44%-67%) and 50% (95%
CI, 36%-61%), respectively. CONCLUSIONS: Distal femur compressive
osseointegration is a viable method for endoprosthetic reconstruction. Rotational
failure is rare with the majority occurring early. No variables were found to
correlate with increased risk of mechanical failure. More research is needed to
evaluate methods of preventing mechanical and rotational failures in addition to
other common causes of revision such as infection in these massive endoprosthetic
reconstructions. LEVEL OF EVIDENCE: Level IV, therapeutic study.
free
free
free
