Endoprosthetic reconstruction of the distal tibia and ankle joint after resection of primary bone tumours.
Endoprosthetic replacement of the distal tibia and ankle joint for a primary bone tumour is a rarely attempted and technically challenging procedure. We report the outcome of six patients treated between 1981 and 2007. There were four males and two females, with a mean age of 43.5 years (15 to 75), and a mean follow-up of 9.6 years (1 to 27). No patient developed a local recurrence or metastasis. Two of the six went on to have a below-knee amputation for persistent infection after a mean 16 months (1 to 31). The four patients who retained their endoprosthesis had a mean musculoskeletal tumour society score of 70% and a mean Toronto extremity salvage score of 71%. All were pain free and able to perform most activities of daily living in comfort. A custom-made endoprosthetic replacement of the distal tibia and ankle joint is a viable treatment option for carefully selected patients with a primary bone tumour. Patients should, however, be informed of the risk of infection and the potential need for amputation if this cannot be controlled.
Royal National Orthopaedic Hospital, Stanmore, Middlesex, England.
A S
AS
Shekkeris
S A
SA
Hanna
M D
MD
Sewell
B G I
BG
Spiegelberg
W J S
WJ
Aston
G W
GW
Blunn
S R
SR
Cannon
T W R
TW
Briggs
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult