Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction
Abstract Diaphyseal prosthetic reconstruction for bone tumors continues to face challenges with failures due to the lack of evidence-based classification systems. This study aimed to develop and validate a novel classification framework to optimize reconstruction strategies through a retrospective a...
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| Format: | Article |
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Nature Portfolio
2025-08-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-12513-6 |
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| author | Leming Mou Miao Zhang Hongyu Wang Jingyu Zhang Dongmu Tian Yongcheng Hu Dengxing Lun |
| author_facet | Leming Mou Miao Zhang Hongyu Wang Jingyu Zhang Dongmu Tian Yongcheng Hu Dengxing Lun |
| author_sort | Leming Mou |
| collection | DOAJ |
| description | Abstract Diaphyseal prosthetic reconstruction for bone tumors continues to face challenges with failures due to the lack of evidence-based classification systems. This study aimed to develop and validate a novel classification framework to optimize reconstruction strategies through a retrospective analysis of 112 patients undergoing diaphyseal prosthetic reconstruction between 2010–2021. Diaphyseal tumors were classified into five types according to anatomical location and residual medullary cavity length, with each category corresponding to a tailored prosthetic reconstruction strategy. Clinical outcomes demonstrated a mean Musculoskeletal Tumor Society score of 24.3 ± 3.3 with comparable functional outcomes across classification types. The overall complication rate was 16.1% (18/112), primarily involving aseptic loosening (ASL, 8%) and structural failures (3.6%), with a reoperation rate of 6.3% (7/112). Notably, Type I reconstructions using standard stems without plates showed the highest complication rate (21%), while Type IIIa reconstructions exhibited no complications. Competing risk model analysis showed that cumulative mortality rates at 0.5, 1, 3, 5, and 8 years were 6.4%, 17.4%, 54.4%, 59.1%, and 66.5%, respectively, while cumulative complication rates were 2.7%, 6.5%, 12.5%, 19.4%, and 22.5%, respectively. These findings establish diaphyseal prostheses as effective solutions for intercalary defect reconstruction, emphasizing their role in facilitating early weight-bearing and functional recovery. The novel classification system for diaphyseal tumors provides valuable guidance for the design and application of prosthetic reconstructions. |
| format | Article |
| id | doaj-art-85f3fdb54625455b82e720b1b50aa1ae |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-85f3fdb54625455b82e720b1b50aa1ae2025-08-20T03:04:30ZengNature PortfolioScientific Reports2045-23222025-08-0115111210.1038/s41598-025-12513-6Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstructionLeming Mou0Miao Zhang1Hongyu Wang2Jingyu Zhang3Dongmu Tian4Yongcheng Hu5Dengxing Lun6WeiFang People’s Hospital, Shandong Second Medical UniversityDepartment of Joint Surgery, WeiFang People’s Hospital, Shandong Second Medical UniversityWeiFang People’s Hospital, Shandong Second Medical UniversityBone Tumor and Soft Tissue Oncology, Tianjin Hospital, Tianjin UniversityShandong Weigao Orthopaedic Device Co.,LtdBone Tumor and Soft Tissue Oncology, Tianjin Hospital, Tianjin UniversityWeiFang People’s Hospital, Shandong Second Medical UniversityAbstract Diaphyseal prosthetic reconstruction for bone tumors continues to face challenges with failures due to the lack of evidence-based classification systems. This study aimed to develop and validate a novel classification framework to optimize reconstruction strategies through a retrospective analysis of 112 patients undergoing diaphyseal prosthetic reconstruction between 2010–2021. Diaphyseal tumors were classified into five types according to anatomical location and residual medullary cavity length, with each category corresponding to a tailored prosthetic reconstruction strategy. Clinical outcomes demonstrated a mean Musculoskeletal Tumor Society score of 24.3 ± 3.3 with comparable functional outcomes across classification types. The overall complication rate was 16.1% (18/112), primarily involving aseptic loosening (ASL, 8%) and structural failures (3.6%), with a reoperation rate of 6.3% (7/112). Notably, Type I reconstructions using standard stems without plates showed the highest complication rate (21%), while Type IIIa reconstructions exhibited no complications. Competing risk model analysis showed that cumulative mortality rates at 0.5, 1, 3, 5, and 8 years were 6.4%, 17.4%, 54.4%, 59.1%, and 66.5%, respectively, while cumulative complication rates were 2.7%, 6.5%, 12.5%, 19.4%, and 22.5%, respectively. These findings establish diaphyseal prostheses as effective solutions for intercalary defect reconstruction, emphasizing their role in facilitating early weight-bearing and functional recovery. The novel classification system for diaphyseal tumors provides valuable guidance for the design and application of prosthetic reconstructions.https://doi.org/10.1038/s41598-025-12513-6Diaphyseal tumorsClassificationSurgical treatmentDiaphyseal prostheses |
| spellingShingle | Leming Mou Miao Zhang Hongyu Wang Jingyu Zhang Dongmu Tian Yongcheng Hu Dengxing Lun Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction Scientific Reports Diaphyseal tumors Classification Surgical treatment Diaphyseal prostheses |
| title | Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction |
| title_full | Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction |
| title_fullStr | Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction |
| title_full_unstemmed | Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction |
| title_short | Classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction |
| title_sort | classification of diaphyseal tumors based on residual medullary cavity length for prosthetic reconstruction |
| topic | Diaphyseal tumors Classification Surgical treatment Diaphyseal prostheses |
| url | https://doi.org/10.1038/s41598-025-12513-6 |
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