1. The use of a non-invasive extendable prosthesis at the time of revision arthroplasty
- Author
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Jonathan Stevenson, Michael Parry, Lee Jeys, R. J. Grimer, Roger M. Tillman, Magdalena M. Gilg, Adesegun Abudu, and Czar Louie Gaston
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Adolescent ,Revision procedure ,medicine.medical_treatment ,Bone Neoplasms ,Prosthesis Design ,Prosthesis ,Amputation, Surgical ,Prosthesis Implantation ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Child ,Leg ,030222 orthopedics ,Revision arthroplasty ,business.industry ,Non invasive ,Leg length ,Mechanical failure ,Prostheses and Implants ,medicine.disease ,Leg Length Inequality ,Surgery ,Treatment Outcome ,Primary bone ,030220 oncology & carcinogenesis ,Female ,Sarcoma ,business - Abstract
AimsThe use of a noninvasive growing endoprosthesis in the management of primary bone tumours in children is well established. However, the efficacy of such a prosthesis in those requiring a revision procedure has yet to be established. The aim of this series was to present our results using extendable prostheses for the revision of previous endoprostheses.Patients and MethodsAll patients who had a noninvasive growing endoprosthesis inserted at the time of a revision procedure were identified from our database. A total of 21 patients (seven female patients, 14 male) with a mean age of 20.4 years (10 to 41) at the time of revision were included. The indications for revision were mechanical failure, trauma or infection with a residual leg-length discrepancy. The mean follow-up was 70 months (17 to 128). The mean shortening prior to revision was 44 mm (10 to 100). Lengthening was performed in all but one patient with a mean lengthening of 51 mm (5 to 140).ResultsThe mean residual leg length discrepancy at final follow-up of 15 mm (1 to 35). Two patients developed a deep periprosthetic infection, of whom one required amputation to eradicate the infection; the other required two-stage revision. Implant survival according to Henderson criteria was 86% at two years and 72% at five years. When considering revision for any cause (including revision of the growing prosthesis to a non-growing prosthesis), revision-free implant survival was 75% at two years, but reduced to 55% at five years.ConclusionOur experience indicates that revision surgery using a noninvasive growing endoprosthesis is a successful option for improving leg length discrepancy and should be considered in patients with significant leg-length discrepancy requiring a revision procedure. Cite this article: Bone Joint J 2018;100-B:370–7.
- Published
- 2018