Abstract
BackgroundAseptic loosening has become the main cause of prosthetic failure in medium- to long-term follow-up. The objective of this study was to establish and validate a nomogram model for aseptic loosening after tumor prosthetic replacement around knee.MethodsWe collected data on patients who underwent tumor prosthetic replacements. The following risk factors were analyzed: tumor site, stem length, resection length, prosthetic motion mode, sex, age, extra-cortical grafting, custom or modular, stem diameter, stem material, tumor type, activity intensity, and BMI. We used univariate and multivariate Cox regression for analysis. Finally, the significant risk factors were used to establish the nomogram model.ResultsThe stem length, resection length, tumor site, and prosthetic motion mode showed a tendency to be related to aseptic loosening, according to the univariate analysis. Multivariate analysis showed that the tumor site, stem length, and prosthetic motion mode were independent risk factors. The internal validation indicated that the nomogram model had acceptable predictive accuracy.ConclusionsA nomogram model was developed for predicting the prosthetic survival rate without aseptic loosening. Patients with distal femoral tumors and those who are applied with fixed hinge and short-stem prostheses are more likely to be exposed to aseptic loosening.
Highlights
The knee joint is a common site for primary and metastatic bone tumors, with reported incidences of 28.4% for benign bone tumors and 46.84% for malignant bone tumors [1]
The treatment for malignant bone tumors around knee has shifted from amputation to limb salvage surgery, in which the tumor prostheses are most commonly selected for the reconstruction of bone defects [2,3,4]
Multivariate Cox regression analysis indicated that the tumor site (HR = 3.99, CI 95% 1.21~13.16, p = 0.023), length of prosthetic stem (HR = 2.84, CI 95% 1.13~7.12, p = 0.026), and prosthetic motion mode (HR = 4.11, CI 95% 1.74~9.70, p = 0.001) were independent risk factors for aseptic loosening (Table 2; Fig. 3)
Summary
The knee joint is a common site for primary and metastatic bone tumors, with reported incidences of 28.4% for benign bone tumors and 46.84% for malignant bone tumors [1]. A multicentric retrospective study for 2174 mature patients treated with artificial prosthetic replacements following tumor resection has shown that aseptic loosening occurred later (76 months) than other types of failure modes with the highest incidence among mechanical. The nomogram model, which transforms traditional statistical predictive models into visualized probability estimates tailored to each patient, is suitable for cancer prognostic studies. This kind of user-friendly graphical representation can allow for clinicians to more explain prognosis information to patients, rather than abstractly presenting them with risk factors. The objective of this study was to establish and validate a nomogram model for aseptic loosening after tumor prosthetic replacement around knee
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
