Application of custom-manufactured artificial total knee prosthesis in limb salvage surgery for patients with a pathologic fracture in osteosarcoma
10.3969/j.issn.2095-4344.2014.26.006
- VernacularTitle:特制人工膝关节假体在骨肉瘤合并病理骨折保肢治疗中的应用
- Author:
Fusheng LI
;
Shaonian XU
;
Hai HUANG
;
Zhenguang DU
;
Liang WANG
- Publication Type:Journal Article
- Keywords:
prosthesis implantation;
osteosarcoma;
fractures,bone;
retrospective studies
- From:
Chinese Journal of Tissue Engineering Research
2014;(26):4131-4135
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Osteosarcoma combined with pathological fracture was often treated by amputation. With clinical application of neoadjuvant chemotherapy and improvement of technology and material of the prosthesis, the limbs of patients with osteosarcoma combined with pathological fracture were reserved. OBJECTIVE:To evaluate the effect of the application of custom-manufactured artificial total knee prosthesis replacement in limb salvage treatment for patients with osteosarcoma combined with pathological fracture. METHODS:A total of 11 patients with pathological fracture with osteosarcoma located in adjacent knee Joint were enrol ed from June 2002 to September 2012. In accordance with individual condition of the patient, limb salvage treatment was designed for knee prosthesis for a tumor. Fol ow-up results were retrospectively analyzed. There were six males (54.5%) and five females (45.5%) and their age ranged from 11 to 50 years old with an average age of 25.4 years old. Onset regions:seven tumors were located in the distal femur and four tumors were in the proximal tibia. Al patients received neoadjuvant chemotherapy, and limb salvage treatment with custom-manufactured artificial knee prosthesis. The fol ow up was performed for 9 to 105 months. RESULTS AND CONCLUSION:In 11 patients after prosthesis replacement, the regional recurrence rates were 18%, lung metastasis rates were 36%. The five-year survival rate was 58%. Four patients developed lung metastases and died in 9 to 24 months postoperatively. During the last fol ow-up, Enneking score of the affected limbs was 11 to 30 points, averagely 23.3 points, with an excellent and good rate of 82%. Results indicated that combined with neoadjuvanet chemotherapy, the application of custom-manufactured artificial total knee prosthesis replacement in the treatment of osteosarcoma located in adjacent knee joint and pathological fracture achieved an ideal outcomes of the limb salvage treatment in the near future. The lone-term effectiveness was expected to be evaluated.
