title: Modular Endoprostheses for Nonneoplastic Conditions: Midterm Complications and Survival.
abstract: The use of modular endoprostheses is a viable option to manage both tumor resection and severe bone loss due to nonneoplastic conditions such as fracture sequelae, failed osteoarticular grafts, arthroplasty revisions, and periprosthetic fractures. We sought to investigate both midterm complications and failures occurred in 87 patients who underwent a megaprosthetic reconstruction in a nonneoplastic setting. After a mean follow-up of 58 (1-167) months, overall failure-free survival was 91.5% at 1 year, 80% at 2 years, 71.6% at 5 years, and 69.1% at 5 and 10 years. There was no significant difference in the survival rate according to the diagnosis at the index procedure (p= 0.921), nor to the reconstruction site (p= 0.402). The use of megaprostheses in a postneoplastic setting did not affect survival rate in comparison with endoprosthetic reconstruction of pure nonneoplastic conditions (p= 0.851). Perimegaprosthetic infection was the leading complication, occurring in 10 (11.5%) patients and implying a megaprosthetic revision in all but one case. Physicians should consider these results when discussing with patients desired outcomes of endoprosthetic reconstructions of a nonneoplastic disease.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
authors.forename: Marco
authors.identifier: 0000-0001-7601-102X
authors.initials: M
authors.lastname: De Gori
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Careggi University Hospital, University of Florence, Florence, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Scoccianti
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Careggi University Hospital, University of Florence, Florence, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Frenos
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Careggi University Hospital, University of Florence, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bettini
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
authors.forename: Filippo
authors.identifier: 0000-0002-3453-2043
authors.initials: F
authors.lastname: Familiari
authors.affiliation: Department of Orthopaedic and Trauma Surgery, "Mater Domini" University Hospital, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.
authors.forename: Giorgio
authors.identifier: 0000-0002-8256-7697
authors.initials: G
authors.lastname: Gasparini
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Careggi University Hospital, University of Florence, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Beltrami
authors.affiliation: Department of Orthopaedic Oncology and Reconstructive Surgery, Careggi University Hospital, University of Florence, Florence, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Cuomo
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Careggi University Hospital, University of Florence, Florence, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: De Biase
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University of Pisa, Pisa, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Capanna
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D019736:Prostheses and Implants / Q000009:adverse effects*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D016019:Survival Analysis; D055815:Young Adult