Intercalary diaphyseal endoprosthetic reconstruction for malignant bone tumors
Abstract
The best method of reconstruction after resection of malignant tumors of the bone diaphysis is unknown. We present a retrospective review of 19 patients who underwent limb salvage using a bone diaphyseal endoprosthetic replacement following excision of a bone tumor. Complications included aseptic loosening in six patients, progression diseases in two and one local recurrence. Six patients required revision surgery. rates of complication and revision were high, but diaphyseal replacement following resection of bone tumors enables early return to function, additional adjuvant treatment and provides an alternative to other surgical options, without apparent compromise of patient survival.
About the Authors
E. A. Sushentsov
N.N. Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Moscow
V. A. Sokolovsky
N.N. Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Moscow
R. M. Kabardaev
N.N. Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Moscow
A. Z. Dzampaev
N.N. Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Moscow
M. S. Kubirov
N.N. Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Moscow
A. P. Nikolaev
N.N. Blokhin Russian Cancer Research Center
Russian Federation
Russian Federation
Moscow
References
1. Clain A. Secondary malignant disease of bone. Br. J. Cancer. 1965, v. 19, p. 15-29.
2. Chang D.W., Weber K.L. Use of a vascularized fibula bone flap and intercalary allograft for diaphyseal reconstruction after resection of primary extremity bone sarcomas. Plast. Reconstr. Surg. 2005, v. 116, p. 1918-1925.
3. Chen C.M., Disa J.J., Lee H.Y. et al. Reconstruction of extremity long bone defects after sarcoma resection with vascularized fibula flaps: a 10-year review. Plast. Reconstr. Surg. 2007, v. 119, p. 915-924.
4. Tsuchiya H., Tomita K., Minematsu K. et al. Limb salvage using distraction osteogenesis. A classification of the technique. J. Bone Joint. Surg. 1997, v. 79-B, p. 403-411.
5. Araki N., Myoui A., Kuratsu S. et al. Intraoperative extracorporeal autogenous irradiated bone grafts in tumor surgery. Clin. Orthop. Relat. Res. 1999, v. 368, p. 196-206.
6. Chen T.H., Chen W.M., Huang C.K. Reconstruction after intercalary resection of malignant bone tumors: comparison between segmental allograft and extracorporeallyirradiated autograft. J. Bone Joint. Surg. 2005, v. 87-B, p. 704-709.
7. Krieg A.H., Davidson A.W., Stalley P.D. Intercalary femoral reconstruction with extracorporeal irradiated autogenous bone graft in limb-salvage surgery. J. Bone Joint. Surg. 2007, v. 89-B, p. 366-371.
8. Deijkers R.L.M., Bloem R.M., Kroon H.M. et al. Epiphyseal versus other intercalary allografts for tumors of the lower limb. Clin. Orthop. Relat. Res. 2005, v. 439, p. 151-160.
9. Donati D., Di Liddo M., Zavatta M. et al. Massive bone allograft reconstruction in high-grade osteosarcoma. Clin. Orthop. Relat. Res. 2000, v. 377, p. 186-194.
10. Muscolo D.L., Ayerza M.A., Aponte-Tinao L., Ranalletta M., Abalo E. Intercalary femur and tibia segmental allografts provide an acceptable alternative in reconstructing tumor resections. Clin. Orthop. Relat. Res. 2004, v. 426, p. 97-102.
11. Ortiz-Cruz E., Gebhardt M.C., Jennings L.C., Springfield D.S., Mankin M.J. The results of transplantation of intercalary allografts after resection of tumors: a longterm follow-up study. J. Bone Joint. Surg. 1997, v. 79-A, p. 97-106.
12. Capanna R., Campanacci D.A., Belot N. et al. A new reconstructive technique for intercalary defects of long bones: the association of massive allograft with vascularized fibular autograft. Long-term results and comparison with alternative techniques. Orthop. Clin. North Am. 2007, v. 38, p. 51-60.
13. Ahlmann E.R., Menendez L.R. Intercalary endoprosthetic reconstruction for diaphyseal bone tumours. J. Bone Joint. Surg. 2006, v. 88-B, p. 1487-1491.
14. Aldlyami E., Abudu A., Grimer R.J., Carter S.R., Tillman R.M. Endoprosthetic replacement of diaphyseal bone defects. Long-term results. Int. Orthop. 2005, v. 29, p. 25-29.
15. Hanna S.A., Sewell M.D., Aston W.J.S. et al. Femoral diaphyseal endoprosthetic reconstruction after segmental resection of primary bone tumors. J. Bone Joint. Surg. 2010, v. 92-B, p. 867-874.
16. Mankin H.J., GebhardtM.C., JenningsL.C., Springfield D.S., Tomford W.W. Long-term results of allograft replacement in the management of bone tumors. Clin. Orthop. Relat. Res. 1996, v. 324, p. 86-97.
17. Zaretski A., Amir A., Meller I. et al. Free fibula long bone reconstruction in orthopedic oncology: a surgical algorithm for reconstructive options. Plast. Reconstr. Surg. 2004, v. 113, p. 1989-2000.
18. Donati D., Capanna R., Campanacci D. et al. The use of massive bone allografts for intercalary reconstruction and arthrodeses after tumor resection. Chir. Organi Mov. 1993, v. 78, p. 81-94.
19. Gebhardt M.C., Flugstad D.I., Springfield D.S., Mankin H.J. The use of bone allografts for limb salvage in high grade osteosarcoma. Clin. Orthop. Relat. Res. 1991, v. 270, p. 181-196.
20. Refaat Y., Gunnoe J., HornicekF.J., Mankin H.J. Comparison of quality of life after amputation or limb salvage. Clin. Orthop. Relat. Res. 2002, v. 397, p. 298-305.
21. Sewell M.D., Spiegelberg B.G., Hanna S.A. et al. Noninvasive extendible endoprostheses for limb reconstruction in skeletally-mature patients. J. Bone Joint. Surg. 2009, v. 91-B, p. 1360-1365.
22. McGrath A., Sewell M.D., Hanna S.A. et al. Custom endoprosthetic reconstruction for malignant bone disease in the humeral diaphysis. Acta Orthop. Belg., 2011, v. 77, p. 171-179.
23. Sewell M.D., Hanna S.A., McGrath A. et al. Intercalary diaphyseal endoprosthetic reconstruction for malignant tibial bone tumors. J. Bone Joint. Surg. [Br.]. 2011, v. 93-B, p. 1111-1117.
24. Spiegelberg B.G.I., Sewell M.D., Aston W.J. et al. The early results of joint-sparing proximal tibial replacement for primary bone tumors, using extracortical plate fixation. J. Bone Joint. Surg. [Br.]. 2009, v. 91-B, p. 1373-1377.
25. Алиев М.Д., Сушенцов Е.А. Современная онкоортопедия. Саркомы костей, мягких тканей и опухоли кожи. 2012, № 4, с. 3-10.
26. Барабаш А.П., Кесов Л.А., БарабашЮ.А., Шпиняк С.П. Замещение обширных диафизарных дефектов длинных костей кончностей. Травматология и ортопедия России. 2014, № 2 (72), с. 93-99.
Review
For citations:
Sushentsov E.A., Sokolovsky V.A., Kabardaev R.M., Dzampaev A.Z., Kubirov M.S., Nikolaev A.P. Intercalary diaphyseal endoprosthetic reconstruction for malignant bone tumors. Bone and soft tissue sarcomas, tumors of the skin. 2014;(3-4):20-25. (In Russ.)
Views:
94
Email this article 
