Infected Prostheses after Lower-Extremity Bone Tumor Resection: Clinical Outcomes of 100 Patients

Mavrogenis, Andreas F.; Pala, Elisa; Angelini, Andrea; Calabrò, Teresa; Romagnoli, Carlo; Romantini, Matteo; Drago, G; Ruggieri, Pietro

doi:10.1089/sur.2014.085

Cited by 50 publications

(63 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our series, estimated infection‐rate (6% and 10% at 5 and 10 years, respectively) was lower than that reported in most of the previous studies, which reported infection rates up to 18% for all sites NIEPR . However, only 12.5% of DF NIEPR developed a deep infection in the series of Gilg et al These data emphasize the reduced risk of infection after DF NIEPR when compared to other sites …”

Section: Discussioncontrasting

confidence: 68%

Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Sambri

Staals

Medellin

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Aims The aim of this study is to assess outcomes of patients ≤12 years who undergo Stanmore noninvasive extendible endoprosthetic replacement of the distal femur (DF NIEPR). Patients and Methods A total of 101 children (mean age 9.6 years) were included. All complications which required further surgery were recorded. Clinical and functional outcomes were evaluated with Musculoskeletal Tumor Society (MSTS) scores at a mean follow‐up of 64 months (range 6‐174). Results Thirty‐one (30.7%) patients died at a mean of 33 months. Forty had prosthesis removed after a mean of 43 months (range, 7‐103). Attaining of the full lengthening potential before skeletal maturity was the most frequent reason for revision surgery, particularly in those with smaller lengthening potential (P = 0.039). Implant survival rate for other causes was 61.7% at 5 years and 45.0% at 10 years. At final follow‐up mean MSTS score was 26 (range, 13‐29). Twenty‐two (21.5%) patients had a final limb‐length discrepancy (LLD) > 2 cm. Conclusions DF NIEPR produces a good functional outcome, with the prevention of major LLD at skeletal maturity in the majority of the cases. We suggest patient selection criteria to account for the stage of the disease due to the high cost of the NIEPR, and high percentage requiring revision, and a 60% mortality rate in those patients presenting with distant disease burden.

show abstract

Section: Discussioncontrasting

confidence: 68%

Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Sambri

Staals

Medellin

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Marvogenis et al, showed similar survival rates of 88% at 10 years after two stage revisions. 11 Angelini, showed knee arthrodesis to be a viable salvage procedure for infected tumour prosthesis. However the success rates for the arthrodesis was only 50% at 5 years.…”

Section: %mentioning

confidence: 99%

“…13 The bacteriological profile in other series is similar to our series with the most common organisms seen being Staphylococcus spp. 5,11,[15][16][17] The sub species varied between studies with certain studies reporting Staph. epidermidis being more common than Staph.…”

Section: %mentioning

confidence: 99%

“…aureus in our study. 5,11,12 Fukagawa et al tried high dose antibiotic infusion in salvage of knee implants with good success rates for total knee arthroplasty (100% ) but infected tumour prosthesis fared poorly (20%). 18 We however performed radical debridement, wound lavage , antibiotics for 6 weeks and VAC in all our patients with excellent results (100% infection free) at 8 months.…”

Section: %mentioning

confidence: 99%

See 1 more Smart Citation

Salvage of infected proximal tibial tumour prosthesis using vacuum assisted closure (VAC) in seven patients

Balasubramanian

Sindhuja

2017

Int J Res Orthop

View full text Add to dashboard Cite

Background: Proximal tibia is the second most common site for both benign and malignant bone tumours. The treatment protocols of such tumours have seen a paradigm shift from amputation towards limb salvage. Limb salvage has been possible with resection and reconstruction using custom modular prosthesis but the risk of tumour recurrence and infection still looms large.Methods: Here we present our series of seven patients with infected proximal tibial tumour prosthesis which were salvaged using vacuum assisted closure (VAC) dressing. The indications for surgery were recurrent giant cell tumour (4 cases), chondrosarcoma (2 cases) and osteosarcoma (one patient). The prosthesis used was the limb preservation system (LPS) [Depuy-Synthes, US]. There were 6 males (M:F 6:1) with average age of 34.23 years. The predominant organism cultured was Staph aureus. We proceeded with radical wound debridement and VAC dressing with continuous negative pressure drainage for an average of 18 days (range 12-24 days). The patients then underwent secondary suturing and delayed suture removal (18-21 days).Results: All 7 patients were well at 8 months follow-up with no recurrent or persistent infection with good functional outcome. The average knee society score (KSS) was 73 (good). Conclusions: We conclude that with early thorough radical debridement and with select bacteriological culture profile, VAC is a valuable tool in the salvage of infected tumour prosthesis. This may reduce the need for amputations of such infected limbs by a significant margin while still retaining good functional outcome.

show abstract

“…Consequently, endoprosthetic replacement surgery using tumor prostheses are today offered to 90% to 95% of all patients suffering from primary malignant bone tumors without compromising the oncological outcome . Amputation can, however, be a salvage procedure in case of a local recurrence of BS or implant failure …”

Section: Introductionmentioning

confidence: 99%

Long‐term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb‐sparing bone resections in orthopedic oncologic conditions: Results from a national cohort

Yilmaz

Sørensen

Saebye

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background and Objectives We investigated implant revision, implant failure, and amputation risk after limb‐sparing bone tumor surgery using the Global Modular Replacement System (GMRS) tumor prosthesis in patients suffering from bone sarcomas (BS), giant cell tumors (GCT), or metastatic bone disease (MBD). Material and Methods A retrospective study of a nationwide consecutive cohort (n = 119, 47 [12‐81] years, M/F = 65/54) having limb‐sparing surgery and reconstruction using the GMRS tumor prosthesis due to bone tumors (BS/GCT/MBD = 70/8/41) from 2005 to 2013. Anatomical locations were as followed: distal femur (n = 49), proximal femur (n = 41), proximal tibia (n = 26), or total femur (n = 3). Kaplan‐Meier survival analysis and competing risk analysis with death as a competing risk were used for statistical analysis. Results For BS and GCT patients, 5‐year patient survival was 72% (95% confidence interval [CI]: 59‐85%) and for MBD 33% (95% CI: 19‐48%). Thirty‐two patients underwent revision surgery (5‐year revision incidence 14%; 95% CI: 8‐21%). Twelve patients had revision of bone‐anchored parts (implant failure) with a 5‐year revision incidence 6% (95% CI: 2‐10%). Ten amputations were performed due to local relapse (n = 9) or recurrent infections (n = 1) with a 5‐year incidence of amputation: 8% (95% CI: 3‐13%). Conclusions We identified a low risk of revision and amputation when using the GMRS tumor prosthesis for limb‐sparing bone tumor.

show abstract

Infected Prostheses after Lower-Extremity Bone Tumor Resection: Clinical Outcomes of 100 Patients

Cited by 50 publications

References 37 publications

Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Stanmore noninvasive extendible endoprosthesis in the treatment of bone sarcoma in the preadolescent

Salvage of infected proximal tibial tumour prosthesis using vacuum assisted closure (VAC) in seven patients

Long‐term results of the Global Modular Replacement System tumor prosthesis for reconstruction after limb‐sparing bone resections in orthopedic oncologic conditions: Results from a national cohort

Contact Info

Product

Resources

About