Functional Outcomes After Limb-Salvage Surgery and Endoprosthetic Reconstruction With an Expandable Prosthesis: A Report of 4 Cases

Beebe, Kathleen S.; Song, Kimberly J.; Ross, Ellen; Tuy, Benjamin; Patterson, Francis; Benevenia, Joseph

doi:10.1016/j.apmr.2008.12.025

Cited by 32 publications

(22 citation statements)

References 44 publications

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“…The Stanmore noninvasive prosthesis also seems easier to expand and more durable with less potential for mechanical failure compared with earlier types of noninvasive prostheses such as the Phenix/Repiphysis. 8,24,25 In the current study, mean MSTS score at final follow-up was 88.7% for the 3 patients (4 limbs) treated with a Stryker or Biomet minimally invasive expandable prosthesis compared with a mean MSTS score of 97% in the 4 patients (4 limbs) treated with the Stanmore noninvasive extendible prosthesis. Patients treated with minimally invasive prostheses suffered from extended pain due to soft tissue in-jury and prosthesis revision, whereas all of the patients reconstructed with a noninvasive prosthesis were pain-free.…”

Section: Discussionmentioning

confidence: 48%

Reconstruction Using Expandable Endoprostheses for Skeletally Immature Patients With Sarcoma

Decilveo¹,

Szczech²,

Topfer³

et al. 2017

Orthopedics

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Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93.3%. Functional outcomes for the noninvasive and minimally invasive expandable prostheses were 97% and 85%, respectively. Complications included temporary peroneal nerve palsy (2 limbs), infection (2 limbs), prosthesis revision (3 limbs), stiffness (3 limbs), and wound healing problems (3 limbs). None of the patients required amputation. Both minimally and noninvasive expandable prostheses appear to be safe and reliable means of reconstruction that permit limb salvage in skeletally immature patients and provide good functional results considering the alternative is above-knee amputation or hip disarticulation. Although complications are frequent (range, 13%-38%), they often can be managed successfully without amputation, thus providing a good quality of life and functional limb. The noninvasive prosthesis may prove to be a more attractive option by potentially negating additional surgeries and reducing infection rates; however, the short-term experience with this prosthesis warrants further investigations with more patients and longer follow-up. [Orthopedics. 2017; 40(1):e157-e163.].

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Section: Discussionmentioning

confidence: 48%

Reconstruction Using Expandable Endoprostheses for Skeletally Immature Patients With Sarcoma

Decilveo¹,

Szczech²,

Topfer³

et al. 2017

Orthopedics

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“…Reduced ipsilateral ground reaction forces may enable patients to extend the ipsilateral hip after initial contact. Weakness in ipsilateral hip extensors in patients who underwent endoprosthetic knee replacement, which has been reported 15 previously (Beebe et al, 2009), may be associated with weaker ipsilateral body support during early stance; however, we did not measure hip muscle strength in the patients. In these patients, we did not observe increased hip extension, which has been reported previously (Rompen et al, 2002), possibly because of the small sample size.…”

Section: Compensation By Ipsilateral Limbmentioning

confidence: 77%

Compensation by nonoperated joints in the lower limbs during walking after endoprosthetic knee replacement following bone tumor resection

Okita

Tatematsu²,

Nagai

et al. 2013

Clinical Biomechanics

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Patients tended to compensate for dysfunction of the reconstructed knee by muscles around the ipsilateral ankle and contralateral hip, with increased load on the contralateral limb during walking. These differences could lead to secondary impairments. Further analysis, including musculoskeletal simulation and assessment of long-term functional outcome with regard to secondary musculoskeletal impairment, is needed to verify the significance of the change in gait and to determine the need for special care for secondary musculoskeletal dysfunction in these patients.

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“…Clinicamente esses pacientes costumam apresentar fraqueza maior para extensão do que para flexão (KENDALL et al, 2000). Nas ressecção distais do fêmur foi encontrado déficit de 21% do torque flexor, no entanto, na literatura os déficits encontrados apresentam grande variação de 2,1% a 50,8% (TSUBOYAMA et al, 1993;BEEBE et al, 2009;BERNTHAL et al, 2015). Para ressecções proximais da tíbia tivemos redução de 36% na força flexora, que foi similar ao encontrado por Bernthal et al, (2015) e Petschnig et al, (1995.…”

Section: Discussão 5 Discussãounclassified

“…Apesar de os resultados funcionais serem considerados bons e excelentes quando se avaliam os valores globais do questionário MSTS (HARDES et al, 2013), Beebe et al, (2009) identificou prejuízo moderado quando apenas os fatores função e marcha são considerados (BEEBE et al, 2009). A avaliação do fator função no questionário é determinada pelas restrições nas atividades e o efeito sobre o estilo de vida do paciente (ENNEKING et al, 1993).…”

Section: Discussão 5 Discussãounclassified

“…No nosso estudo, quanto maior o tempo de fisioterapia, menor foi a redução do torque para extensão do joelho, sugerindo que deve ser dada ênfase à reabilitação e ao fortalecimento constante desses indivíduos, para a manutenção ou melhora da força muscular, pois o tempo pós-operatório, por si só, não contribui para melhora espontânea da força de extensão. Beebe et al, (2009) relataram que mesmo apos um seguimento de 31,5 meses, os pacientes mantinham deficiência da força muscular para flexão e extensão (BEEBE et al, 2009). Nos pacientes submetidos a reconstruções com endoprótese de joelho, que são jovens acometidos por tumores ósseos primários (MYERS et al, 2007;ETCHEBEHERE et al, 2016) a demanda por atividade física é maior que nos idosos submetidos a artroplastia (GRIMER, 2005) e a fraqueza muscular tem impacto maior sobre a sua vida social e profissional (HARRIS et al, 1990).…”

Section: Discussão 5 Discussãounclassified

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Avaliação funcional retrospectiva de pacientes com tumor ósseo tratados com endoprótese

Prada¹

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Ao Professor Dr. Edgard Eduard Engel por ter ensinado e orientado, com muita calma e paciência. Por ser inspiração como profissional, que cuida e atende com muito carinho cada paciente e que me permitiu vivenciar e participar do Ambulatório de Oncologia Ortopédica (AONO), com sua equipe multiprofissional. Essa experiência me proporcionou muito conhecimento e aprendizado. Ao Professor Dr. Daniel Augusto de Carvalho Maranho, por ter permitido que eu chegasse até aqui. A equipe do Ambulatório de Oncologia Ortopédica, em especial a Amira, por sempre confiar e acreditar no meu trabalho e ao Nelson, por ser, além de educador, uma inspiração no cuidado e atenção ao paciente. Aos meus pais por terem me apoiado, auxiliado e acreditarem nos meus sonhos. Ao meu amado, Carlos, por acreditar em mim, me dar todo apoio, paciência, companheirismo, amizade e amor. Obrigada por todos os dias me fazer feliz! Aos amigos que vivenciaram, torceram e desejaram essa conquista comigo, de perto ou de longe. A cada paciente, que além de ceder seu tempo para que essa pesquisa pudesse ser realizada, trouxeram histórias e ensinamentos para a vida. Vou lembrar de cada um com muito carinho. A CAPES pela bolsa concedida.

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Functional Outcomes After Limb-Salvage Surgery and Endoprosthetic Reconstruction With an Expandable Prosthesis: A Report of 4 Cases

Cited by 32 publications

References 44 publications

Reconstruction Using Expandable Endoprostheses for Skeletally Immature Patients With Sarcoma

Reconstruction Using Expandable Endoprostheses for Skeletally Immature Patients With Sarcoma

Compensation by nonoperated joints in the lower limbs during walking after endoprosthetic knee replacement following bone tumor resection

Avaliação funcional retrospectiva de pacientes com tumor ósseo tratados com endoprótese

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