title: Cause of infection in proximal tibial endoprosthetic reconstructions.
abstract: BACKGROUND
  The underlying cause of proximal tibial prosthetic failure by infection is unclear. We asked: (1) Is resection amount related to prosthetic infection? (2) What other risk factors are related with infection? (3) What are the survivorship and functional outcomes of proximal tibial endoprosthetic reconstruction?
  
  
  METHODS
  Sixty-two patients who underwent modular proximal tibial megaprosthesis reconstruction were analyzed. Follow-up duration averaged 98 months (range 26-240 months). Associations between prognostic variables and prosthesis survival were assessed.
  
  
  RESULTS
  The 10-year prosthetic survival of the 62 implants was 73.9 ± 11.7%. Prostheses were removed in 16 (25.8%) patients for infection and 3 of the 16 underwent amputation. Resection of >37% (P = 0.016) of the tibia was found to be related to infection. Application of chemotherapy (P = 0.912) and use of synthetic material to fix the patella tendon (P = 0.2) were not found to influence prosthetic survival. Functional outcomes (determined by the MSTS system) of the 52 patients that maintained a mobile joint averaged 24.2 (81%) (range 18-28).
  
  
  CONCLUSIONS
  Our study suggests that the amount of bone resection is related with prosthetic failure by infection, however, the contribution of other risk factors should not be underestimated.
authors.affiliation: Department of Orthopedic Surgery, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul 139-706, Korea.
authors.forename: Wan Hyeong
authors.initials: WH
authors.lastname: Cho
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Song
authors.forename: Dae-Geun
authors.initials: DG
authors.lastname: Jeon
authors.forename: Chang-Bae
authors.initials: CB
authors.lastname: Kong
authors.forename: Jung Il
authors.initials: JI
authors.lastname: Kim
authors.forename: Soo-Yong
authors.initials: SY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013977:Tibia / Q000601:surgery*; D055815:Young Adult