Modular prosthesis reconstruction after tumour resection, evaluation of failures and survival

Abstract

ObjectiveTo analyse a series of patients with bone tumours reconstructed with modular prostheses and to evaluate: (1) Survival of the implant. (2) Causes of failure. (3) Complication rates. (4) Limb salvage overall survival. (5) Functional results and full weight bearing. Materials and methodsA retrospective study from longitudinally maintained oncology databases was undertaken. All patients with bone tumours reconstructed with endoprosthesis were analysed. A total of 106 patients matched the inclusion criteria. They were divided into groups: group 1, primary bone tumours; group 2, bone metastasis; group 3, osteoarticular allograft reconstruction revisions. The type of failures were classified according to Henderson et al. (2014) and functional results assessed by the Musculoskeletal Tumor Society (MSTS). Demographic analysis, survival and the differences between groups were recorded. ResultThe mean follow-up of the patients was 68 months. Mean age was 43 years. Overall implant survival was 86.4% at 2 years (95% CI: 79–94) and 73% at 5 years (95% CI: 60–80). Nineteen patients (18%) developed a prosthetic failure. The limb salvage overall survival was 96% at 5 years (95% CI: 91–99). The mean functional results according to the MSTS was 24 and mean time to full weight bearing was 2.3 weeks. ConclusionsLimb conservation surgery and endosprosthetic reconstruction is a valid option for patients with bone tumours with failure rates similar to other reconstruction methods.