Complex reconstruction in the management of extremity sarcomas

Current Opinion in Oncology

Volumn 15, Issue 4, 2003, Pages 304-312

  Wodajo, Felasfa M ^a   Bickels, Jacob ^b   Wittig, James ^b   Malawer, Martin ^a  

^a WASHINGTON CANCER INSTITUTE   (United States)

^b C2173 Washington Cancer Institute ^*

Author keywords

Allograft bone sarcoma; Endoprosthesis reconstruction; Shoulder; Survival knee

Indexed keywords

ACETABULUM; ALLOGRAFT; ARTHRODESIS; ARTHROPATHY; BONE DEFECT; CANCER SURGERY; CHILD; ENDOPROSTHESIS; FEMUR; HIP DISLOCATION; HIP SURGERY; HUMAN; IMPLANT; KNEE SURGERY; LIMB SALVAGE; OSTEOSARCOMA; PRIORITY JOURNAL; REVIEW; SCAPULA; SHOULDER GIRDLE; SOFT TISSUE; SURGEON;

BONE NEOPLASMS; EXTREMITIES; HUMANS; PROSTHESES AND IMPLANTS; PROSTHESIS IMPLANTATION; RECONSTRUCTIVE SURGICAL PROCEDURES; SARCOMA; SURVIVAL RATE;

EID: 0042237972     PISSN: 10408746     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001622-200307000-00005     Document Type: Review

References (38)

1. Enneking WF, Shirley PD: Resection-arthrodesis for malignant and potentially malignant lesions about the knee using an intramedullary rod and local bone grafts. J Bone Joint Surg Am 1977, 59:223-236.
2. Gebhardt MC, Flugstad DI, Springfield DS, et al: The use of bone allografts for limb salvage in high-grade extremity osteosarcoma. Clin Orthop 1991, 270:181-196.
3. Mankin HJ, Doppelt SH, Sullivan TR, et al: Osteoarticular and intercalary allograft transplantation in the management of malignant tumors of bone. Cancer 1982, 50:613-630.
4. Brigman BE, Hornicek FJ, Gebhardt MC, et al: Allograft Reconstructions in Young Patients with High-Grade Sarcomas about the Knee. Paper presented at the annual meeting of the American Academy of Orthopaedic Surgeons, Dallas, TX, 2002. Available at: http://www.aaos.org/wordatml/anmt2002/scicess.htm. Retrospective review of osteochondral allografts at one institution. The authors make note of the rate of fracture, infection, and nonunion complications leading to implant failures.
5. Tsuchiya H, Abdel-Wanis ME, Sakurakichi K, et al: Osteosarcoma around the knee: intraepiphyseal excision and biological reconstruction with distraction osteogenesis. J Bone Joint Surg Br 2002, 84:1162-1166.
6. Bickels J, Wittig JC, Kollender Y, et al: Distal femur resection with endoprosthetic reconstruction: a long-term followup study. Clin Orthop 2002, 400:225-235. A large consecutive series of 110 patients who had distal femur resection and endoprosthetic reconstruction. The overall prosthetic survival was 93% at 5 years and 88% at 10 years.
7. Yasko AW, Rutledge J, Tolley S, et al: The Finn Rotating Hinge Segmental Knee Prosthesis Clinical Results at 5-10 year Follow Up. Paper presented at the annual meeting of the Musculoskeletal Tumor Society; Toronto, Canada, 2002. Available at: http://msts.org/Meetings/MSTS/2002/index.htm
8. Mittermayer F, Windhager R, Dominkus M, et al: Revision of the Kotz type of tumour endoprosthesis for the lower limb. J Bone Joint Surg Br 2002, 84:401-406. A single-institution review of 251 patients over a period of 15 years using uncemented endoprostheses in the lower limb. The probability of a patient avoiding aseptic loosening for 10 years was 96% for a proximal femoral, 76% for a distal femoral, and 85% for a proximal tibial implant.
9. Plotz W, Rechl H, Burgkart R, et al: Limb salvage with tumor endoprostheses for malignant tumors of the knee. Clin Orthop 2002, 405:207-215. Report on 64 consecutive knee endoprostheses between 1976 and 1996. Fifty-eight reoperations were done in 29 patients because of complications. The probability of survival of the leg of the patient after 10 years was 95%.
10. Wodajo FM, Wittig JC, Graney KK, et al: Low Complication Rate with Limb-Sparing Resection and Endoprosthetic Reconstruction: Survival Analysis of 251 Patients and Analysis of 20-Year Experience. Paper presented at the annual meeting of the American Academy of Orthopedic Surgeons; New Orleans, 2003. Available at: http://www.aaos.org/wordhtml/prevmeet.htm. A single institution review of 251 patients with endoprosthetic reconstructions over 20 years detailing types of complications and prosthetic survival. Overall modular prosthesis survival was 94% at a median of 30 months and 86% at 5 years.
11. Neel MD, Wilkins RM, Rao BN, et al: Early Experience with a Non-Invasive Expandable Prosthesis for Reconstruction following Tumor Resection about the Knee. Paper presented at the annual meeting of the Musculoskeletal Tumor Society; Toronto, Canada, 2002. Available at: http://msts.org/Meetings/MSTS/2002/index.htm. The authors describe early experience with a new type of expandable prosthesis that uses a noninvasive method of lengthening. This type of implant may be advantageous for very young children who require lower extremity reconstructions.
12. Berlin OK, Bergh P, Gunterberg B, et al: Autobiological Reconstruction with Preserved Joint Function After Surgical Treatment of Bone Sarcomas in Children. In Proceedings of the Connective Tissue Oncologic Society; San Francisco, 2002.
13. El-Gammal TA, El-Sayed A, Kotb MM: Microsurgical reconstruction of lower limb bone defects following tumor resection using vascularized fibula osteoseptocutaneous flap. Microsurgery 2002, 22:193-198. A study of 25 patients with lower limb reconstruction by vascularized fibula osteoseptocutaneous flap. Significant hypertrophy (≥30% of original fibular diameter) occurred in 85% of patients after an average period of 10 months from the index operation.
14. Heller L, Phillips K, Levin LS: Pedicled osteocutaneous fibula flap for reconstruction in the lower extremity. Plast Reconstr Surg 2002, 109:2037-2042.
15. Chang HC, Pho RW, Kumar VP, et al: Extremity osteosarcoma: a Southeast Asian experience. Ann Acad Med Singapore 2002, 31:598-606.
16. Deijkers RL, Bloem RM, Hogendoorn PC, et al: Hemicortical allograft reconstruction after resection of low-grade malignant bone tumours. J Bone Joint Surg Br 2002, 84:1009-1014.
17. Donati D, Giacomini S, Gozzi E, et al: Allograft arthrodesis treatment of bone tumors: a two-center study. Clin Orthop 2002, 400:217-224. The authors review results of 92 consecutive allograft-arthrodeses of the knee and conclude that the procedure should not be used further unless there are specific indications.
18. Moon BS, Scarborough MT, Worrell D: Long Term Follow-Up of Patients With Allograft Arthrodesis of the Knee. In Proceedings of the American Academy of Orthopedic Surgeons; New Orleans, 2003.
19. Malawer MM, Chou LB: Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcomas. J Bone Joint Surg Am 1995, 77:1154-1165.
20. Bickels J, Meller I, Henshaw RM, et al: Reconstruction of hip stability after proximal and total femur resections. Clin Orthop 2000, 400:218-230.
21. Johnson ME, Mankin HJ: Reconstructions after resections of tumors involving the proximal femur. Orthop Clin North Am 1991, 22:87-103.
22. Kabukcuoglu Y, Grimer RJ, Tillman RM, et al: Endoprosthetic replacement for primary malignant tumors of the proximal femur. Clin Orthop 1999, X:8-14.
23. Ilyas I, Pant R, Kurar A, et al: Modular megaprosthesis for proximal femoral tumors. Int Orthop 2002, 26:170-173. Fifteen patients with endoprosthetic reconstruction of proximal femur are reviewed. The most frequent complication was hip dislocation, at 20%.
24. Donati D, Giacomini S, Gozzi E, et al: Proximal femur reconstruction by an allograft prosthesis composite. Clin Orthop 2002, 394:192-200. Twenty-seven patients with an allograft prosthesis composite reconstruction of the hip are reported. In most of the patients, the prosthesis was a long-stem revision type, cemented in the allograft and uncemented in the femoral shaft. The authors conclude that results compare favorably with those of endoprosthetic reconstruction, with which they state a Trendelenburg gait is common.
25. Farid Y, Lin PP, Weber KL, et al: A comparison of endoprosthetic and allograft-prosthetic composite reconstruction after major resection of the proximal femur for bone neoplasms. In Proceedings of the American Academy of Orthopedic Surgeons; New Orleans, 2003.
26. Bickels J, Wittig JC, Kollender Y, et al: Limb-sparing resections of the shoulder girdle. J Am Coll Surg 2002, 194:422-435. The authors summarize the oncologic and functional results of 134 shoulder resections, emphasizing the need for extra-articular resections for high-grade sarcomas.
27. Ozaki T, Putzke M, Rodl R, et al: Incidence and mechanisms of infiltration of sarcomas in the shoulder. Clin Orthop 2002, 395:209-215.
28. Wittig JC, Bickels J, Kellar-Graney KL, et al: Osteosarcoma of the proximal humerus: long-term results with limb-sparing surgery. Clin Orthop 2002, X:156-176. Twenty-three patients who underwent extra-articular resections and endoprosthetic reconstruction with local muscle transfers for osteosarcoma are reported. Musculoskeletal tumor society functional scores ranged from 80 to 90%. There were no local recurrences or prosthetic failures.
29. Rodl RW, Gosheger G, Gebert C, et al: Reconstruction of the proximal humerus after wide resection of tumours. J Bone Joint Surg Br 2002, 84:1004-1008.
30. Amin SN, Ebeid WA: Shoulder reconstruction after tumor resection by pedicled scapular crest graft. Clin Orthop 2002, 397:133-142.
31. Wittig JC, Bickels J, Wodajo F, et al: Constrained total scapula reconstruction after resection of a high-grade sarcoma. Clin Orthop 2002, X:143-155. A new design for a scapular endoprosthesis using a "snap-fit" mechanism between the humerus and scapular components is described. The authors emphasize the clinical indications, prosthetic design, surgical technique, and early functional results.
32. Wodajo FM, Bickels J, Wittig JC, et al: Reconstruction with Scapular Endorprosthesis Provides Superior Results after Total Scapular Resection: Surgical Technique and Comparison to Patients Without Endoprosthetic Reconstruction. In Proceedings of the Musculoskeletal Tumor Society; Toronto, Canada, 2002. The authors compare functional results in 23 patients with total scapular resections, 7 of whom underwent reconstruction with a scapular endoprosthesis. The prosthesis group had improved functional scores and significantly improved abduction and cosmesis. There were no prosthetic failures.
33. Enneking WF, Dunham WK: Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am 1978, 60:731-746.
34. Ozaki T, Hoffmann C, Hillmann A, et al: Implantation of hemipelvic prosthesis after resection of sarcoma. Clin Orthop 2002, X:197-205.
35. Schwameis E, Dominkus M, Krepler P, et al: Reconstruction of the pelvis after tumor resection in children and adolescents. Clin Orthop 2002, 402:220-235.
36. Fuchs B, O'Connor MI, Kaufman KR, et al: Iliofemoral arthrodesis and pseudarthrosis: a long-term functional outcome evaluation. Clin Orthop 2002, 397:29-35. Thirty-two patients underwent iliofemoral arthrodesis after resections of pelvic tumors. The radiographic union rate was 86%, and biomechanical analysis showed that the loss of motion in the hip is well compensated. The authors conclude that this method provides durable oncologic and functional long-term results.
37. Grimer RJ, Belthur M, Chandrasekar C, et al: Two-stage revision for infected endoprostheses used in tumor surgery. Clin Orthop 2002, 395:193-203. The authors used a two-stage reimplantation for deep infection following endoprosthetic reconstruction in 34 patients and were able to obtain impressive overall success rates of 91% at 1 year and 74% at 5 years. Six patients required amputation.
38. Suk KS, Shin KH, Hahn SB: Limb salvage using original low heat-treated tumor-bearing bone. Clin Orthop 2002, 397:385-393.