Late Complications and Survival of Endoprosthetic Reconstruction after Resection of Bone Tumors

摘要: While complications following massive endoprosthetic reconstruction have been previously described, the incidence and effects of these over extended periods time not well characterized in large series. We therefore determined: (1) types complications; (2) relative risk (3) likelihood secondary (4) whether modularity altered such (5) implant failure limb salvage rates (6) survival followup. retrospectively reviewed 232 patients (241 implants: 50 custom,191 modular) who underwent for malignant aggressive bone tumors between 1980 2002. Complications were classified as infection, mechanical, superficial soft tissue, deep or dislocation. Survival was determined by Kaplan-Meier analysis. Minimum followup 5 years (mean: 10 years; range: 5–27 years). One hundred thirty-seven (59%) a single reconstruction. Ninety-five had 242 additional procedures. Forty-four revised retained their original prosthesis. Limb rate 90%; (removal cemented part) seen 29% (70/241) with median 190 months. Twenty-five custom implants failed (8 then again) while 30/180 modular (7 again). Of 70 instances failure, 38/70 27/70 infectious. Risk infection increased 30% after second procedure; 16 24 amputations performed because infection. Mechanical most common cause failure. Infection leading both complication amputation; substantially revision surgery. Modular fewer mechanical complications, thus to revisions subsequent infections. Level III, therapeutic study. See guidelines authors complete description levels evidence.