ArticleJournal of orthopaedic surgery and research2021
Megaendoprostheses in the management of malignant tumors of the lower extremities-risk factors for revision surgery.
Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Prolonged prophylactic antibiotic use following megaprosthesis surgery may reduce periprosthetic infection.Journal of orthopaedics · 2024Article
- Limited Revision with a Newly Designed Hinge Device for the Treatment of Mega-Prosthesis Hinge Failure: Two Case Reports.Orthopaedic surgery · 2024Article
- Management of complications of mega-implants following treatment of primary and periprosthetic fractures of the lower extremities.Scientific reports · 2023Article
- Risk of Interprosthetic Femur Fracture Is Associated with Implant Spacing-A Biomechanical Study.Journal of clinical medicine · 2023Article
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5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundImproved oncological and surgical measures now enable curative treatment of malignant lower extremity tumors in majority of cases. Complication rates associated with surgical resection of lower extremity tumors and replacement with megaendoprostheses are high. The aim of this study was to identify risk factors that predispose to revision surgery following the use of megaimplants in curative treatment of malignant tumors of the lower extremities.
methodsthis retrospective study included patients aged ≥ 18 years who underwent implantation of a megaendoprosthesis for tumors or metastatic lesions of the lower extremities between January 2010 and December 2020. Baseline characteristics and information on adjuvant treatment, hospitalization time, comorbidities, mobility, complications, and revision surgery were considered. Primary outcomes were revision surgery and reasons for revision. Secondary outcomes were in-hospital complications and the duration of hospitalization.
resultsFifty-four patients (48% female, age 63 years, SD 15) were available for final analysis. Surgeries were performed at hip level in 37 patients (68.5%) and at knee level in 17 patients (31.5%). Revision for wound-related causes was performed in 12 cases (22.2%), with microbiological proof of infection in 8 cases (14.8%). Revision for hip joint instability was carried out in 4 cases (7.4%) and for disconnection between components of the megaimplant in 2 cases (3.7%). Those patients requiring a wound-related revision had undergone a longer primary surgical intervention than those who required an implant-related revision (276 vs 134 min, p = .002). Wound drains after the primary implantation remained longer in situ in patients who later required revision surgery for wound-related complications (5 vs 3 days, p = .020). An ASA > 3 was associated with an increased likelihood for in-hospital complications in general (p = .041), and in-hospital death in particular (p = .012).
conclusionsThe management of malignant tumors of the lower extremities with megaendoprostheses is associated with a high rate of wound-related complications. Swift surgical performance and early postoperative removal of wound drains minimize the risk of complications in general and the necessity of revision surgery in particular. Patients with more comorbidities were more likely to suffer in-hospital complications.
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