Reconstruction with Custom Unicondylar Hemiarthroplasty following Tumor Resection: A Case Series and Review of the Literature.

For patients with tumors of the distal femur, options for limb salvage include tumor resection followed by reconstruction. While reconstruction commonly involves a distal femoral replacement, careful selection of patients with tumor involvement limited to a single condyle may be candidates for reconstruction with distal femur hemiarthroplasty. In these procedures, resection spares considerably more native anatomy. Three consecutive patients who underwent resection and reconstruction at the distal femur with custom unicondylar hemiarthroplasty are presented in this case series at a mean follow-up of 45 months (range, 26-78). In two cases, prostheses were utilized as a secondary procedure after failure of initial reconstruction. In one case, the custom prosthesis was utilized as the primary method of reconstruction. Mean Musculoskeletal Tumor Society disease-specific scores were 26.7 (range, 25-28). All patients achieved a return to full weight bearing, activities of daily living, and functional range of motion. In appropriately selected patients with tumors of the distal femur, reconstruction with custom unicondylar hemiarthroplasty provides benefits including optimal function postoperatively via preservation of tumor-free bone and ligamentous structures. Additionally, maintenance of greater bone stock may confer benefits to patients with pathology at a high likelihood for recurrence and need for subsequent procedures.
Competing Interests: J. B. reports personal fees from Merete Inc, grants from Musculoskeletal Transplant Foundation, personal ffees from Implant Cast, other from CreOsso LLC, outside the submitted work; in addition, J. B. has a patent LOCALIZED INSULIN DELIVERY FOR BONE HEALING 7,763,582 PCT/US07/62521 12/280,085 licensed to CreOsso LLC, a patent INSULIN-MIMETIC LOCAL THERAPEUTIC ADJUNCTS FOR BONE REGENERATION PCT/US12/67087 (61/564,822) licensed to CreOsso LLC, a patent IMPLANTABLE DEVICES COATED WITH INSULIN-MIMETIC AGENT COMPOSITES AND METHODS THEREOF PCT/US11/64240 (61/428,342) (61/421,921) licensed to CreOsso LLC, a patent USE OF VANADIUM COMPOUNDS TO ACCELERATE BONE HEALING PCT/US11/21296 (61/295,234) 2011205741 11-2012-017535-1 2,787,208 11733440.9 2012-549109 10-2012-7021191 601391 13/522,075 13106008.2 licensed to CreOsso LLC, and a patent INSULIN-MIMETIC LOCAL THERAPEUTIC ADJUNCTS FOR ENHANCING SPINAL FUSION 61/718,646 licensed to CreOsso LLC and Licensing fees from CreOsso LLC to Rutgers patent holders.
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