title: Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection.
abstract: Short metaphyseal segments remaining after distal femoral tumor resection pose a unique challenge. Limb sparing options include a short stemmed modular prosthesis, total endoprosthetic replacement, cross-pin fixation to a custom implant, and allograft prosthetic composite reconstruction (APC). A series of patients with APC reconstruction were evaluated to determine functional and radiologic outcome and complication rates. Twelve patients were retrospectively identified who had a distal femoral APC reconstruction between 1994 and 2007 to salvage an extremity with a segment of remaining bone that was less than 20 centimeters in length. Seventeen APC reconstructions were performed in twelve patients. Eight were primary procedures and nine were revision procedures. Average f/u was 89 months. Twelve APC reconstructions (71%) united and five (29%) were persistent nonunions. At most recent followup 10 patients (83%) had a healed APC which allowed WBAT. One pt (8%) had an amputation and one pt (8%) died prior to union. Average time to union was 19 months. Four pts (33%) or five APC reconstructions (29%) required further surgery to obtain a united reconstruction. Although Distal Femoral APC reconstruction has a high complication rate, a stable reconstruction was obtained in 83% of patients.
authors.affiliation: MD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USA.
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Moon
authors.affiliation: Greater Dallas Orthopaedics, 12230 Coit Road, Suite 100, Dallas, TX 75251, USA.
authors.forename: Nathan F
authors.initials: NF
authors.lastname: Gilbert
authors.affiliation: Polyclinic Department of Orthopaedic Surgery, 1001 Broadway, Suite 109, Seattle, WA 98122, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.affiliation: MD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USA.
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Lin
authors.affiliation: MD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USA.
authors.forename: Valerae O
authors.initials: VO
authors.lastname: Lewis