Abstract
BackgroundAs for being cautious with tumor prostheses, revision of uncemented tumor prostheses in particular, it is necessary to remove cortical bone from the stem circumference with a chisel when the stem is extracted. This assures that bone in-growth will occur within the stem in itself. As a result, re-substitution of mass autogenous bone graft round a new stem is subsequently necessary. When rivision of uncemented tumor prosthesis of distal femur was performed, we evade fibula transplant by transplanting interconnected porous hydroxyapatite ceramic (IP-CA: Neobone) with a self bone, and reports its experience with the case that acquired enough strength.Case reportIn this report, we present the case of a 27-year-old female with stem breakage of tumor prosthesis and do revision surgery for prosthetic failure. In the case of revision surgery, autologous bone and Neobone were mixed, and this was transplanted to stem circumference. The Radiological Evaluation System of the ISOLS showed excellent results for all items. She can walk without using a cane or orthosis, and the score of the MSTS is 80%.ConclusionWhen revision of uncemented tumor prostheses of the distal femur was performed, we avoided fibula graft by using Neobone with the patient's own bone tissue. Our experience with this case may indicate that adequate strength is achieved.
Highlights
As for being cautious with tumor prostheses, revision of uncemented tumor prostheses in particular, it is necessary to remove cortical bone from the stem circumference with a chisel when the stem is extracted
In surgery for malignant bone tumors, the implantation of joint prostheses for tumors after wide resection is an important reconstruction method. Complications such as infection and prosthesis fracture develop in some cases [1,2]
A 27-year-old female was referred to our hospital on May 16, 1996 and admitted due to a suspected malignant bone tumor in the left distal femur
Summary
In surgery for malignant bone tumors, the implantation of joint prostheses for tumors (tumor prostheses) after wide resection is an important reconstruction method. Complications such as infection and prosthesis fracture develop in some cases [1,2]. Seven weeks after the operation, walking training was initiated using a knee orthosis with gradual weight bearing. About one year after surgery, good bone formation around the stem is observed on plain X-ray films. Excellent results for all items (Bone remodeling, Interface, Anchorage) after as well as before the operation (Fig. 3) She can walk without using a cane or orthosis, and the score of the Musculoskeletal Tumor Society is 80%
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