Minghui Li1, Xin Xiao1, Junjun Fan1, Yajie Lu1, Guojing Chen1, Mengquan Huang1, Chuanlei Ji1, Zhen Wang1, Jing Li2. 1. Department of Orthopedics, Xi Jing Hospital, Air Force Medical University, Xi'an, Shaanxi, People's Republic of China. 2. Department of Orthopedics, Xi Jing Hospital, Air Force Medical University, Xi'an, Shaanxi, People's Republic of China. 13359265058@189.cn.
Abstract
BACKGROUND: Reconstruction of a massive bone defect caused by previous failed limb-salvage surgery in patients with bone sarcoma is challenging. Many procedures have been used, but they all have their inherent disadvantages. The Capanna technique has demonstrated good functional outcomes and a low incidence of complications in primary reconstructive surgery of massive bone defect. However, few studies have focused on its usage in revision surgery after failed primary limb-salvage surgery. METHODS: Between June 2011 and January 2017, 13 patients underwent revision surgery with the Capanna technique for reconstruction of a secondary segmental bone defect caused by a previous failed surgical procedure. The demographics, operating procedures, graft union, functional outcomes, oncologic outcomes, and postoperative complications of each patient were recorded. RESULTS: The current study investigated 13 patients. The rate of limb salvage was 100 %. Bone union was achieved for all patients during a mean time of 8.54 ± 2.15 months (range 4-11 months) at the fibula-host bone junction and 14.92 ± 2.33 months (range 12-21 months) at the allograft-host bone junction. The postoperative complications included wound healing issues and internal fixation loosening. Allograft fracture, nonunion, and infection were not observed. All the patients achieved good functional outcomes, with a Musculoskeletal Tumor Society (MSTS) score of 0.86 ± 0.03 at the latest follow-up visit. CONCLUSIONS: The Capanna technique is a reliable alternative method for revision reconstruction of a segmental bone defect caused by a previous failed surgical procedure. LEVEL OF EVIDENCE: Level IV, therapeutic study.
BACKGROUND: Reconstruction of a massive bone defect caused by previous failed limb-salvage surgery in patients with bone sarcoma is challenging. Many procedures have been used, but they all have their inherent disadvantages. The Capanna technique has demonstrated good functional outcomes and a low incidence of complications in primary reconstructive surgery of massive bone defect. However, few studies have focused on its usage in revision surgery after failed primary limb-salvage surgery. METHODS: Between June 2011 and January 2017, 13 patients underwent revision surgery with the Capanna technique for reconstruction of a secondary segmental bone defect caused by a previous failed surgical procedure. The demographics, operating procedures, graft union, functional outcomes, oncologic outcomes, and postoperative complications of each patient were recorded. RESULTS: The current study investigated 13 patients. The rate of limb salvage was 100 %. Bone union was achieved for all patients during a mean time of 8.54 ± 2.15 months (range 4-11 months) at the fibula-host bone junction and 14.92 ± 2.33 months (range 12-21 months) at the allograft-host bone junction. The postoperative complications included wound healing issues and internal fixation loosening. Allograft fracture, nonunion, and infection were not observed. All the patients achieved good functional outcomes, with a Musculoskeletal Tumor Society (MSTS) score of 0.86 ± 0.03 at the latest follow-up visit. CONCLUSIONS: The Capanna technique is a reliable alternative method for revision reconstruction of a segmental bone defect caused by a previous failed surgical procedure. LEVEL OF EVIDENCE: Level IV, therapeutic study.
Authors: Paul T Ogink; Frederik R Teunissen; Julie R Massier; Kevin A Raskin; Joseph H Schwab; Santiago A Lozano-Calderon Journal: J Surg Oncol Date: 2018-12-05 Impact factor: 3.454
Authors: Georgios N Panagopoulos; Andreas F Mavrogenis; Cyril Mauffrey; Jan Lesenský; Andrea Angelini; Panayiotis D Megaloikonomos; Vasilios G Igoumenou; John Papanastassiou; Olga Savvidou; Pietro Ruggieri; Panayiotis J Papagelopoulos Journal: Eur J Orthop Surg Traumatol Date: 2017-06-05
Authors: J I Albergo; L C Gaston; G L Farfalli; M Laitinen; M Parry; M A Ayerza; M Risk; L M Jeys; L A Aponte-Tinao Journal: Musculoskelet Surg Date: 2019-03-08
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