Application of custom-manufactured artificial total knee prosthesis in limb salvage surgery for patients with a pathologic fracture in osteosarcoma

doi:10.3969/j.issn.2095-4344.2014.26.006

Abstract

Abstract:

BACKGROUND: Osteosarcoma combined with pathological fracture was often treated by amputation. With clinical application of neoadjuvant chemotherapy and improvement of technology and material of the prosthesis, the limbs of patients with osteosarcoma combined with pathological fracture were reserved.
OBJECTIVE: To evaluate the effect of the application of custom-manufactured artificial total knee prosthesis replacement in limb salvage treatment for patients with osteosarcoma combined with pathological fracture.
METHODS: A total of 11 patients with pathological fracture with osteosarcoma located in adjacent knee Joint were enrolled from June 2002 to September 2012. In accordance with individual condition of the patient, limb salvage treatment was designed for knee prosthesis for a tumor. Follow-up results were retrospectively analyzed. There were six males (54.5%) and five females (45.5%) and their age ranged from 11 to 50 years old with an average age of 25.4 years old. Onset regions: seven tumors were located in the distal femur and four tumors were in the proximal tibia. All patients received neoadjuvant chemotherapy, and limb salvage treatment with custom-manufactured artificial knee prosthesis. The follow up was performed for 9 to 105 months.
RESULTS AND CONCLUSION: In 11 patients after prosthesis replacement, the regional recurrence rates were 18%, lung metastasis rates were 36%. The five-year survival rate was 58%. Four patients developed lung metastases and died in 9 to 24 months postoperatively. During the last follow-up, Enneking score of the affected limbs was 11 to 30 points, averagely 23.3 points, with an excellent and good rate of 82%. Results indicated that combined with neoadjuvanet chemotherapy, the application of custom-manufactured artificial total knee prosthesis replacement in the treatment of osteosarcoma located in adjacent knee joint and pathological fracture achieved an ideal outcomes of the limb salvage treatment in the near future. The lone-term effectiveness was expected to be evaluated.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: prosthesis implantation, osteosarcoma, fractures, bone, retrospective studies

CLC Number:

R318

Li Fu-sheng, Xu Shao-nian, Huang Hai, Du Zhen-guang, Wang Liang . Application of custom-manufactured artificial total knee prosthesis in limb salvage surgery for patients with a pathologic fracture in osteosarcoma [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(26): 4131-4135.

Figures/Tables 3

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