ArticleArchives of orthopaedic and trauma surgery2022
Mid-term implant survival, functional and radiological results and mechanical complications of mega-prosthetic reconstruction around the knee with the PENTA® system.
Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Outcomes over 30 years after megaprosthetic reconstruction of the lower limb following tumor resection: a retrospective case series of 10 patients.Japanese journal of clinical oncology · 2026Article
- Failure Modes in Orthopedic Oncologic Reconstructive Surgery: A Review of Imaging Findings and Failure Rates.Current oncology (Toronto, Ont.) · 2024Review
- Functional audit of the use of megaprosthesis for limb reconstruction in musculoskeletal tumors - A retrospective single-center study.Journal of orthopaedics · 2024Article
- Aseptic loosening of tumor prostheses in distal femur after revision surgery: a retrospective study.World journal of surgical oncology · 2023Article
- Implant Survival, Clinical Outcome and Complications of Megaprosthetic Reconstructions Following Sarcoma Resection.Cancers · 2022Review
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimMega-prosthetic reconstruction is the most common treatment method for massive osteoarticular defects caused by tumor resection around the knee. The new implant is a highly modular rotational-hinged megaprosthesis system with a distinct pentagonal stem geometry and variable implantation options. The aim of this study is to present the mid-term implant survival characteristics, functional and radiological results and mechanical complication profile of the new megaprosthesis.
methodsOne hundred and one mega-prosthetic knee reconstruction procedures in 90 patients (M/F: 51/39) utilizing the new implant system were retrospectively analyzed. In 68 patients, the megaprosthesis was used for primary reconstruction following tumor resection while it was used for revision of other implants in 22. The mean age was 28.5 (7-66) years and the mean follow-up was 59.2 (24-124) months. The most common primary pathology was osteosarcoma with 63-70% patients, the most common anatomical site of involvement was the distal femur with 56-62% patients.
resultsHenderson Type 2 failure (aseptic loosening) was seen in only 2-2.2% patients while Type 3 (structural failure) was seen in 29-32.2% Although the 5-year anchorage survival rate was 94.3%, overall mechanical implant survival was 76.1% at 5 years due to a relatively high failure rate in the first-generation hinge mechanism of the implant. The 5-year hinge survival rate demonstrated a significant improvement rate from 61.7% to 87.2% between the first and second generations of the implant (p = 0.027). The mean MSTS score was 24 out of 30 (14-29). The mean cumulative ISOLS radiographic score for index megaprosthesis operations was 19.7 (12-24), which corresponded to excellent outcome.
conclusionThe new megaprosthesis system is a reliable choice for the reconstruction of tumor-related massive osteoarticular defects around the knee. Although long-term follow-up is necessary for a definitive evaluation of the implant's survival characteristics, midterm follow-up yields exceptional anchorage properties related to pentagonal stem geometry with very good functional outcomes.
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