Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates

Limb salvage surgeries utilizing endoprostheses and allografts are performed for a variety of oncologic conditions. These reconstructions can fail and require revision for many reasons, which are outlined and classified into mechanical failures (soft tissue failures, aseptic loosening, structural fa...

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Main Authors: Anuj Shah, Fabiano N. Cardoso, Felipe Souza, Julien Montreuil, Juan Pretell-Mazzini, H. Thomas Temple, Francis Hornicek, Brooke Crawford, Ty K. Subhawong
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/31/10/465
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author Anuj Shah
Fabiano N. Cardoso
Felipe Souza
Julien Montreuil
Juan Pretell-Mazzini
H. Thomas Temple
Francis Hornicek
Brooke Crawford
Ty K. Subhawong
author_facet Anuj Shah
Fabiano N. Cardoso
Felipe Souza
Julien Montreuil
Juan Pretell-Mazzini
H. Thomas Temple
Francis Hornicek
Brooke Crawford
Ty K. Subhawong
author_sort Anuj Shah
collection DOAJ
description Limb salvage surgeries utilizing endoprostheses and allografts are performed for a variety of oncologic conditions. These reconstructions can fail and require revision for many reasons, which are outlined and classified into mechanical failures (soft tissue failures, aseptic loosening, structural failure), non-mechanical failures (infection, tumor progression), and pediatric failures (physeal arrest, growth dysplasia). Distinct radiologic and clinical findings define specific failure subtypes but are sparsely illustrated in the radiology literature. Specifically, an understanding of the organizational structure of the failure modes can direct radiologists’ search for post-reconstruction complications, enhance an appreciation of their prognostic significance, and facilitate research by standardizing the language and conceptual framework around outcomes. The purpose of this review is to highlight the key radiologic findings and imaging studies of each failure mode in orthopedic oncologic reconstructive surgery in the context of risk factors, failure rates, prognosis and survival statistics, and clinical decision-making regarding chemotherapy, radiation, and revision surgery.
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series Current Oncology
spelling doaj-art-cc3100fe9b5d495187bfada98ff539942025-08-20T02:11:09ZengMDPI AGCurrent Oncology1198-00521718-77292024-10-0131106245626610.3390/curroncol31100465Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure RatesAnuj Shah0Fabiano N. Cardoso1Felipe Souza2Julien Montreuil3Juan Pretell-Mazzini4H. Thomas Temple5Francis Hornicek6Brooke Crawford7Ty K. Subhawong8Miller School of Medicine, University of Miami, Miami, FL 33136, USADepartment of Radiology, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL 33136, USADepartment of Radiology, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL 33136, USADepartment of Orthopedic Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USAMiami Cancer Institute, Division of Orthopedic Oncology, Baptist Health System South Florida, Plantation, FL 33324, USADepartment of Orthopedic Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USADepartment of Orthopedic Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USADepartment of Orthopedic Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USADepartment of Radiology, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL 33136, USALimb salvage surgeries utilizing endoprostheses and allografts are performed for a variety of oncologic conditions. These reconstructions can fail and require revision for many reasons, which are outlined and classified into mechanical failures (soft tissue failures, aseptic loosening, structural failure), non-mechanical failures (infection, tumor progression), and pediatric failures (physeal arrest, growth dysplasia). Distinct radiologic and clinical findings define specific failure subtypes but are sparsely illustrated in the radiology literature. Specifically, an understanding of the organizational structure of the failure modes can direct radiologists’ search for post-reconstruction complications, enhance an appreciation of their prognostic significance, and facilitate research by standardizing the language and conceptual framework around outcomes. The purpose of this review is to highlight the key radiologic findings and imaging studies of each failure mode in orthopedic oncologic reconstructive surgery in the context of risk factors, failure rates, prognosis and survival statistics, and clinical decision-making regarding chemotherapy, radiation, and revision surgery.https://www.mdpi.com/1718-7729/31/10/465orthopedic oncologyreconstructive surgeryfailure modesHenderson classificationrevision surgerylimb salvage
spellingShingle Anuj Shah
Fabiano N. Cardoso
Felipe Souza
Julien Montreuil
Juan Pretell-Mazzini
H. Thomas Temple
Francis Hornicek
Brooke Crawford
Ty K. Subhawong
Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates
Current Oncology
orthopedic oncology
reconstructive surgery
failure modes
Henderson classification
revision surgery
limb salvage
title Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates
title_full Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates
title_fullStr Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates
title_full_unstemmed Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates
title_short Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates
title_sort failure modes in orthopedic oncologic reconstructive surgery a review of imaging findings and failure rates
topic orthopedic oncology
reconstructive surgery
failure modes
Henderson classification
revision surgery
limb salvage
url https://www.mdpi.com/1718-7729/31/10/465
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