BACKGROUND: Previous studies reported variable outcome of proximal tibial resections and reconstructions. Therefore, we evaluated the survival, Musculoskeletal Tumor Society (MSTS) function, and complications of patients and reconstructions in this location. MATERIALS AND METHODS: We reviewed the files of 225 patients with proximal tibial tumors treated with proximal tibial resection, fixed or rotating hinge megaprosthetic reconstruction and extensor mechanism reattachment using sutures, mechanical clamping, artificial ligaments, and/or gastrocnemius flap from 1985 to 2010 (mean follow-up, 90 months; median, 56; range, 2-294). Survival of patients and reconstructions, type of hinge, extensor mechanism reconstruction, MSTS function, and complications were analyzed. RESULTS: Survival of patients with sarcomas was 68% and 62% at 5 and 10 years. Survival of megaprosthetic reconstructions was 82% and 78% at 5 and 10 years, without any difference between fixed and rotating hinge megaprostheses. MSTS function was significantly better in univariate and multivariate analysis for rotating compared to fixed hinge megaprostheses, without any difference between the types of extensor mechanism reconstructions. Most common complications were infection (12%), aseptic loosening (6%), and extensor mechanism rupture (3%). CONCLUSIONS: Rotating hinge proximal tibia megaprosthetic reconstructions have better function compared to fixed hinge, regardless of the type of extensor mechanism reconstruction.
BACKGROUND: Previous studies reported variable outcome of proximal tibial resections and reconstructions. Therefore, we evaluated the survival, Musculoskeletal Tumor Society (MSTS) function, and complications of patients and reconstructions in this location. MATERIALS AND METHODS: We reviewed the files of 225 patients with proximal tibial tumors treated with proximal tibial resection, fixed or rotating hinge megaprosthetic reconstruction and extensor mechanism reattachment using sutures, mechanical clamping, artificial ligaments, and/or gastrocnemius flap from 1985 to 2010 (mean follow-up, 90 months; median, 56; range, 2-294). Survival of patients and reconstructions, type of hinge, extensor mechanism reconstruction, MSTS function, and complications were analyzed. RESULTS: Survival of patients with sarcomas was 68% and 62% at 5 and 10 years. Survival of megaprosthetic reconstructions was 82% and 78% at 5 and 10 years, without any difference between fixed and rotating hinge megaprostheses. MSTS function was significantly better in univariate and multivariate analysis for rotating compared to fixed hinge megaprostheses, without any difference between the types of extensor mechanism reconstructions. Most common complications were infection (12%), aseptic loosening (6%), and extensor mechanism rupture (3%). CONCLUSIONS: Rotating hinge proximal tibia megaprosthetic reconstructions have better function compared to fixed hinge, regardless of the type of extensor mechanism reconstruction.
Authors: Jendrik Hardes; Marcel-Philipp Henrichs; Georg Gosheger; Wiebke Guder; Markus Nottrott; Dimosthenis Andreou; Eike Bormann; Maria Eveslage; Gregor Hauschild; Arne Streitbürger Journal: Int Orthop Date: 2018-03-22 Impact factor: 3.075
Authors: Kaarel Kilk; Jessica Ehne; Jonathan D Stevenson; Gilber Kask; Jyrki Nieminen; Rikard Wedin; Michael C Parry; Minna K Laitinen Journal: Acta Orthop Date: 2021-01-07 Impact factor: 3.717
Authors: Stephan E Puchner; Paul Kutscha-Lissberg; Alexandra Kaider; Joannis Panotopoulos; Rudolf Puchner; Christoph Böhler; Gerhard Hobusch; Reinhard Windhager; Philipp T Funovics Journal: PLoS One Date: 2015-08-13 Impact factor: 3.240