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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Main Authors: Bryan S. Moon, Nathan F. Gilbert, Christopher P. Cannon, Patrick P. Lin, Valerae O. Lewis
Format: Article
Language:English
Published: Wiley 2013-01-01
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.
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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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