1.Outcome of Surgical Fixation for Midfoot Charcot Neuroarthropathy - A Systematic Review
Malaysian Orthopaedic Journal 2023;17(No.1):27-33
Introduction: Charcot arthropathy is a condition which is
progressive, non-infectious, destructive and debilitating that
commonly affect foot and ankle. This systematic review is to
evaluate the occurrence of common outcomes associated
with each intervention of Charcot neuroarthropathy in
midfoot.
Materials and methods: A systematic review on literatures
that were published from Jan 2010 to Jan 2020 were
collected, reviewed and selected regarding the surgical
treatment procedures of Charcot neuroarthropathy in
midfoot.
Results: The initial search yielded 231 reports and after
exclusion, nine out of the total studies were included in the
outcome analysis for review. These were studies that
included data concerning surgical reconstruction of Charcot
arthropathy in the midfoot.
Conclusion: It is suggested that soft tissue preparation and
usage of combination of implants thus reduce the risk of
infection as well as increase rigidity of construct,
respectively. These factors will aid to improve outcome of
midfoot Charcot arthropathy reconstruction.
2.Outcome of Endoprosthesis used in Limb Salvage Surgery in a Malaysian Orthopaedic Oncology Centre
Ng YH ; Chai YC ; Mazli N ; Jaafar NF ; Ibrahim S
Malaysian Orthopaedic Journal 2024;18(No.1):60-65
Introduction: To describe the duration of survival among
bone tumour patients with endoprosthesis reconstruction and
to determine frequency of implant failure, revision of
surgery, and amputation after endoprosthesis reconstruction.
Materials and methods: A retrospective cross-sectional
review of all patients with either primary bone tumour or
secondary bone metastases treated with en bloc resection and
endoprosthesis reconstruction from January 2008 to
December 2020.
Results: A total of 35 failures were recorded among the 27
(48.2%) patients with endoprostheses. Some of the patients
suffered from one to three types of modes of failure on
different timelines during the course of the disease. Up to
eight patients suffered from more than one type of failure
throughout the course of the disease. Out of all modes of
failure, local recurrence (type 5 failure) was the most
common, accounting for 25.0% of all failure cases. Four
patients (7.1%) eventually underwent amputation, which
were either due to infection (2 patients) or disease
progression causing local recurrence (2 patients).
Conclusion: The overall result of endoprosthesis
reconstruction performed in our centre was compatible with
other centres around the world. Moreover, limb salvage
surgery should be performed carefully in a selected patient
group to maximise the benefits of surgery.