Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection. (17th November 2013)

• Record Type: Journal Article
• Authors: Moon, Bryan S.; Gilbert, Nathan F.; Cannon, Christopher P.; Lin, Patrick P.; Lewis, Valerae O.
• Other Names: Carl Allen L. Academic Editor.
• Is Part Of: Advances in orthopedics. Volume 2013(2013)
• Publication Date: 2013-11-17
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedics; Electronic journals; Periodicals; Periodicals; 616.7
• DOI: 10.1155/2013/397456
• Languages: English
• ISSNs: 2090-3464

Abstract

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.