Long-term results of individual primary and revision oncological endoprosthetics replacements of ankle joint region with lesions of benign and malignant bone tumors

Abstract

Introdaction. In the general structure of oncological endoprosthetics, primary lesions of the distal tibia are rarely affected. Endoprosthetics of the ankle joint region are associated with characteristic difficulties consisting in soft tissue deficiency and restoration of the biomechanics of the lost joint. The existing scientific volume of the literature data on primary ankle replacement is insignificant. At the moment, there is no experience and clear strategy in revision endoprosthetics of this area, complications remain insufficiently explored.Objective. The aim of the study was a discrete analysis of medium- and long-term results, the structure of complications, and functional results in a group of patients after primary and repeated oncological ankle replacement.Materials and methods. The study included 20 patients with benign and malignant bone tumors, who from July 2008 to November 2019 underwent 33 primary and revision replacements in case of distal tibia tumor lesion. In the study group of patients, 70 % were diagnosed with a primary malignant tumor and 30 % had a benign lesion of the tibia. The mean follow-up period was 58,6 months.Results. The leading complication after primary and revision endoprosthetics was early aseptic instability (type IIA) – 20,0 and 23,1 %, respectively. Primary and revision endoprosthetics survival after 5 years was 40,1 ± 12 %.Conclusion. The average functional result after primary and revision ankle replacement was evaluated according to the MSTS scale and after 6 months was 70,5 % and varied from 40 to 87 %. After 12 months, this figure was 76 % and ranged from 46,7 to 96,7 %.The choice of an endoprosthesis, taking into account the optimal biomechanics design of the endoprosthesis unit, methods of fixation, the introduction of innovative technological solutions in the design, materials of the endoprosthesis, adherence to the principle of radicalism will become a means of reducing the frequency of complications.