Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection
Short metaphyseal segments remaining after distal femoral tumor resection pose a unique challenge. Limb sparing options include a short stemmed modular prosthesis, total endoprosthetic replacement, cross-pin fixation to a custom implant, and allograft prosthetic composite reconstruction (APC). A ser...
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Format: | Article |
Language: | English |
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Wiley
2013-01-01
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Series: | Advances in Orthopedics |
Online Access: | http://dx.doi.org/10.1155/2013/397456 |
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author | Bryan S. Moon Nathan F. Gilbert Christopher P. Cannon Patrick P. Lin Valerae O. Lewis |
author_facet | Bryan S. Moon Nathan F. Gilbert Christopher P. Cannon Patrick P. Lin Valerae O. Lewis |
author_sort | Bryan S. Moon |
collection | DOAJ |
description | Short metaphyseal segments remaining after distal femoral tumor resection pose a unique challenge. Limb sparing options include a short stemmed modular prosthesis, total endoprosthetic replacement, cross-pin fixation to a custom implant, and allograft prosthetic composite reconstruction (APC). A series of patients with APC reconstruction were evaluated to determine functional and radiologic outcome and complication rates. Twelve patients were retrospectively identified who had a distal femoral APC reconstruction between 1994 and 2007 to salvage an extremity with a segment of remaining bone that was less than 20 centimeters in length. Seventeen APC reconstructions were performed in twelve patients. Eight were primary procedures and nine were revision procedures. Average f/u was 89 months. Twelve APC reconstructions (71%) united and five (29%) were persistent nonunions. At most recent followup 10 patients (83%) had a healed APC which allowed WBAT. One pt (8%) had an amputation and one pt (8%) died prior to union. Average time to union was 19 months. Four pts (33%) or five APC reconstructions (29%) required further surgery to obtain a united reconstruction. Although Distal Femoral APC reconstruction has a high complication rate, a stable reconstruction was obtained in 83% of patients. |
format | Article |
id | doaj-art-a8d009df06ec4378834e1795f0c256f1 |
institution | Kabale University |
issn | 2090-3464 2090-3472 |
language | English |
publishDate | 2013-01-01 |
publisher | Wiley |
record_format | Article |
series | Advances in Orthopedics |
spelling | doaj-art-a8d009df06ec4378834e1795f0c256f12025-02-03T05:44:54ZengWileyAdvances in Orthopedics2090-34642090-34722013-01-01201310.1155/2013/397456397456Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor ResectionBryan S. Moon0Nathan F. Gilbert1Christopher P. Cannon2Patrick P. Lin3Valerae O. Lewis4MD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USAGreater Dallas Orthopaedics, 12230 Coit Road, Suite 100, Dallas, TX 75251, USAPolyclinic Department of Orthopaedic Surgery, 1001 Broadway, Suite 109, Seattle, WA 98122, USAMD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USAMD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USAShort metaphyseal segments remaining after distal femoral tumor resection pose a unique challenge. Limb sparing options include a short stemmed modular prosthesis, total endoprosthetic replacement, cross-pin fixation to a custom implant, and allograft prosthetic composite reconstruction (APC). A series of patients with APC reconstruction were evaluated to determine functional and radiologic outcome and complication rates. Twelve patients were retrospectively identified who had a distal femoral APC reconstruction between 1994 and 2007 to salvage an extremity with a segment of remaining bone that was less than 20 centimeters in length. Seventeen APC reconstructions were performed in twelve patients. Eight were primary procedures and nine were revision procedures. Average f/u was 89 months. Twelve APC reconstructions (71%) united and five (29%) were persistent nonunions. At most recent followup 10 patients (83%) had a healed APC which allowed WBAT. One pt (8%) had an amputation and one pt (8%) died prior to union. Average time to union was 19 months. Four pts (33%) or five APC reconstructions (29%) required further surgery to obtain a united reconstruction. Although Distal Femoral APC reconstruction has a high complication rate, a stable reconstruction was obtained in 83% of patients.http://dx.doi.org/10.1155/2013/397456 |
spellingShingle | Bryan S. Moon Nathan F. Gilbert Christopher P. Cannon Patrick P. Lin Valerae O. Lewis Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection Advances in Orthopedics |
title | Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection |
title_full | Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection |
title_fullStr | Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection |
title_full_unstemmed | Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection |
title_short | Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection |
title_sort | distal femur allograft prosthetic composite reconstruction for short proximal femur segments following tumor resection |
url | http://dx.doi.org/10.1155/2013/397456 |
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