Survival of tumor megaprostheses replacements about the knee.
Limb salvage surgery is an effective procedure with a low risk of tumor recurrence. In an attempt to define the incidence of implant failure at 2, 5, and 10 years postoperatively, we retrospectively reviewed implant survival in a group (n = 105) of pediatric (< 18 years of age) and adult patients who were treated with distal femoral and/or proximal tibial implants for extremity tumors. Issues regarding the timing of failure, reason for failure, and whether pediatric patients had higher rates of failure were posed as secondary questions. The median followup was 57 months (1-235 months). Thirty-two (32/105, 31%) patients had 42 implant failures. The mean prosthesis Kaplan-Meier survivorship of the index group was 84% at 2 years, 73% at 5 years, and 59% at 10 years. Forty-seven percent of all failures occurred within 2 years postoperatively, and 69% occurred within 5 years postoperatively. Pediatric patients had a higher failure rate than adults (42% versus 24%). Aseptic loosening was the most common reason for failure (n = 18/32; 56%). The incidence of failure in tumor megaprostheses is similar to early published literature and the incidence of these failures is highest within the first 3 years.


METHODS
Therapeutic study, level IV.
Morgan
Hannah D
HD
Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Seattle, WA 98195, USA. amorgan2@u.washington.edu
Cizik
Amy M
AM
Leopold
Seth S
SS
Hawkins
Douglas S
DS
Conrad
Ernest U
EU
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery