L Goebel1, D Kohn1, P Orth2. 1. Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, Gebäude 37-38, 66421, Homburg/Saar, Deutschland. 2. Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Kirrberger Straße 100, Gebäude 37-38, 66421, Homburg/Saar, Deutschland. patrick.orth@uks.eu.
Abstract
BACKGROUND: Endoprosthetic replacement is a valuable treatment option following intercalary resection of bone tumours in the diaphysis. OBJECTIVES: To identify indication, operative technique, implants currently available, literature results and alternative procedures for the alloplastic reconstruction of segmental bone defects. MATERIALS AND METHODS: This review article summarizes the authors' own experiences and relevant clinical studies focussing on this topic. RESULTS: According to the literature, 10-year-survival rates of intercalary endoprostheses range between 64 and 80%. Yet, comparisons between different publications are difficult due to the limited number of cases, different implants, follow-up periods and the heterogeneous patient populations. Biological alternatives for reconstruction are autologous bone transplantation, distraction osteogenesis and bone transport, allogenic bone transplantation, and the induced membrane technique. Innovative tissue engineering approaches are still limited to preclinical testing. CONCLUSIONS: Short- to mid-term results for segmental endoprostheses following intercalary resections are satisfactory and may be regarded as superior to those of biological reconstructions due to the immediate full weight-bearing capability. However, they are mainly applied for elderly patients and in palliative situations because of potential long-term complications.
BACKGROUND: Endoprosthetic replacement is a valuable treatment option following intercalary resection of bone tumours in the diaphysis. OBJECTIVES: To identify indication, operative technique, implants currently available, literature results and alternative procedures for the alloplastic reconstruction of segmental bone defects. MATERIALS AND METHODS: This review article summarizes the authors' own experiences and relevant clinical studies focussing on this topic. RESULTS: According to the literature, 10-year-survival rates of intercalary endoprostheses range between 64 and 80%. Yet, comparisons between different publications are difficult due to the limited number of cases, different implants, follow-up periods and the heterogeneous patient populations. Biological alternatives for reconstruction are autologous bone transplantation, distraction osteogenesis and bone transport, allogenic bone transplantation, and the induced membrane technique. Innovative tissue engineering approaches are still limited to preclinical testing. CONCLUSIONS: Short- to mid-term results for segmental endoprostheses following intercalary resections are satisfactory and may be regarded as superior to those of biological reconstructions due to the immediate full weight-bearing capability. However, they are mainly applied for elderly patients and in palliative situations because of potential long-term complications.
Entities:
Keywords:
Allogenic bone transplantation; Autologous bone transplantation; Callotasis; Diaphysis; Sarcoma
Authors: Rodolfo Capanna; Domenico A Campanacci; Nicolas Belot; Giovanni Beltrami; Marco Manfrini; Marco Innocenti; Massimo Ceruso Journal: Orthop Clin North Am Date: 2007-01 Impact factor: 2.472