Lower limb reconstruction in tumor patients using modular silver-coated megaprostheses with regard to perimegaprosthetic joint infection: a case series, including 100 patients and review of the literature

Schmolders, Jan; Koob, Sebastian; Schepers, P.; Pennekamp, P. H.; Gravius, Sascha; Wirtz, Dieter Christian; Placzek, Richard; Strauß, Andreas C.

doi:10.1007/s00402-016-2584-8

Cited by 47 publications

(34 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Modular prosthetic implants are useful in major metastases and subtrochanteric involvement. The repeated proneness to infection mentioned in this context can also be reduced in cases of femur replacement by the use of silvercoated models, as confirmed by a study in our hospital [43].…”

Section: Wide Resectionsupporting

confidence: 71%

Bone Metastases – Pathophysiology, Diagnostic Testing and Therapy (Part 2)

et al. 2019

View full text Add to dashboard Cite

The second part of this review deals with the several options for the surgical therapy of bone metastases according to their anatomical site and the patientʼs individual prognosis. Although metastases to the bone – with few exceptions – are normally given palliative therapy, patients nowadays reach survival times of several months to years, depending on the underlying tumour entity. Scoring systems are suitable to estimate the patientʼs prognosis and fracture risk. The indication for operation has to be adapted to these parameters. In order to preserve a high quality of life, a limb saving procedure has to be aimed at. The options include the resection of the metastasis with stabilisation, the sole stabilisation of the affected bone, and wide resection with limb reconstruction using a modular tumor endoprosthesis. With todayʼs anaesthesiological peri- and intraoperative care, a vast number of surgical implants and bone augmentations are available. However, what is important is not the practicability of the procedure, but the oncological justification and patient-adapted selection of surgical therapy.

show abstract

Section: Wide Resectionsupporting

confidence: 71%

Bone Metastases – Pathophysiology, Diagnostic Testing and Therapy (Part 2)

et al. 2019

View full text Add to dashboard Cite

show abstract

“…22 In addition, a significantly lower reinfection rate was observed in those patients treated with silver-coated implants (0 vs. 46%), either as EPR or KA modular implants, as previously reported. 27 Silver-coated EPR and KA implants have demonstrated a significant reduction in infection rates when used in primary EPR, 28 as well encouraging results in reducing reinfection rate when used for the treatment of resistant PJI of the knee. 29 The amputation for infection estimated rate at 10 years was similar to that reported in a previous similar series.…”

Section: Discussionmentioning

confidence: 99%

Is Arthrodesis a Reliable Salvage Option following Two-Stage Revision for Suspected Infection in Proximal Tibial Replacements? A Multi-Institutional Study

et al. 2018

View full text Add to dashboard Cite

The aim of this multicentric retrospective study was to verify whether knee arthrodesis (KA) is a viable reconstructive option after two-stage revision for infection of proximal tibia (PT) endoprosthetic reconstruction (EPR). Sixty patients who underwent a two-stage revision were included. Definitive EPR or a KA with a modular system was performed following consideration of soft tissue and extensor mechanism conditions. Patients were evaluated with Musculoskeletal Tumor Society Score and Oxford Knee Score. Implant survival was assessed on the basis of recurrence of infection. Five patients did not receive any reconstruction after the first stage. In 14 cases, a KA was performed, and in 41, an EPR was implanted. At 5 years follow-up, reinfection rate in the KA group was lower (10 vs. 17.5% in KA and EPR groups, respectively). In reinfected patients, the KA group had a reduced rate of amputation when compared with those with EPR (50 vs. 88%). Functional evaluation did not show any significant differences between the two groups. A successful KA using a modular implant can eradicate infection and allow preservation of the limb with good function and good pain relief in after two-stage revision for an infected PT EPR.

show abstract

“…The most common adverse events associated with modular revision implants are dislocation, aseptic loosening and periprosthetic infection. Using silver-coated implants helped to reduce the postoperative infection rate [30].…”

Section: Lower Extremitymentioning

confidence: 99%