title: [Effects of reconstruction with unicondylar osteoarticular allografts with or without prosthesis for bone tumors around knee joint].
abstract: Objective:To investigate the survival rate, function outcomes, and complications after using unicondylar osteoarticular allografts with or without prosthesis to reconstruct the knee joint for tumors located in distal femoral or proximal tibial uni-condyle.Methods:Twenty-two patients who underwent unicondylar osteoarticular allografts with or without prosthesis composite reconstructions from January 2007 to December 2015 in Department of Orthopaedic Surgery of Xi Jing Hospital, the Fourth Military Medical University were retrospectively reviewed. There were 14 males and 8 females and the mean age was 35 years(8-65 years). There were 12 malignent tumors and 10 aggressive benign tumors. The tumors were located in distal femur in 14 cases and proximal tibia in 8 cases. After tumor excision, the distal femur was reconstructed with unicondylar osteoallograft-prosthesis composite, and proximal tibial plate was reconstructed with unicondylar osteoarticular allograft with the help of computer-assisted navigation system. Function and radiograph were documented according to the Musculoskeletal Tumor Society (MSTS) functional scoring system and the International Society of Limb Salvage (ISOLS) radiographic scoring system. The median follow-up time was 60 months (5-116 months).Results:At the latest follow-up, 2 patients had amputation owing to local recurrence in 12 malignant tumors. Three patients had pulmonary metastasis and 1 patient died another 2 alive with disease. Kaplan-Meier analysis indicated that the disease-free survival rate was 73%. There was no recurrence and metastasis in 10 patients with giant cell tumor. The average MSTS score was 26 points and the radiographic score was 78%-94%(average 90%). The complications included superficial infection in 1 patient and screw broken in 1 patient. There was no broken or collapse allograft in all composite reconstruction patients but 6 cases in allograft reconstruction.Conclusions:Unicondylar osteoarticular allografts or prosthesis composite was feasible reconstruction for tumors in distal femoral uni-condyle. It could provide good functional outcomes and also prevent joint degeneration. Similarly, allograft reconstruction was also a reliable technique for proximal tibial defect.
authors.affiliation: Department of Orthopaedic Surgery, Xi Jing Hospital, the Fourth Military Medical University, Xi'an 710032, China.
authors.forename: Y S
authors.initials: YS
authors.lastname: Xue
authors.forename: J
authors.initials: J
authors.lastname: Fu
authors.forename: Z
authors.initials: Z
authors.lastname: Guo
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: Y J
authors.initials: YJ
authors.lastname: Pei
authors.forename: L L
authors.initials: LL
authors.lastname: Dang
authors.forename: H B
authors.initials: HB
authors.lastname: Fan
mesh_terms: D000328:Adult; D064591:Allografts; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation; D018572:Disease-Free Survival; D005260:Female; D005269:Femur; D006801:Humans; D053208:Kaplan-Meier Estimate; D007719:Knee Joint; D007720:Knee Prosthesis; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013977:Tibia; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: Bone neoplasms; Femur; Tibia; Unicondylar