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Modular megaprostheses for lower-extremity reconstruction offers few complications
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Recently published data demonstrated the use of modular megaprostheses for reconstruction of skeletal defects caused by sarcomas of the lower extremities resulted in a low risk of mechanical complications and a high limb salvage rate.
Researchers retrospectively analyzed 52 patients who underwent surgery for bone sarcomas in the lower extremities with subsequent reconstruction using the METS cemented modular megaprostheses implant system (Stanmore Implants). Twenty-seven reconstructions were performed with a METS distal femur prosthesis, 13 reconstructions were completed with a proximal femur prosthesis, 11 reconstructions were completed with a proximal tibia prosthesis and one was completed with a total femoral implant.
Mean follow-up was 4.3 years. The researchers documented overall patient survival, prosthesis survival, limb salvage rate and secondary complications. Radiographs were taken postoperatively to ensure the implants were appropriately placed. Additionally, the researchers reviewed records of reoccurring complications and defined them as either mechanical or non-mechanical.
Fourteen patients required additional surgery for complications of any kind, and 15% had major revision surgery resulting in implant failure, according to the researchers. Implant survival at 3 years and 5 years was estimated at 83% and 79%, respectively.
According to the researchers, nonmechanical complications were observed in seven patients, accounting for 88% of failures and 100% of amputations. Four of the patients underwent amputations, and two of the patients’ amputations failed due to deep infection.
Three patients had mechanical complications; however, none resulted in amputations.
Overall, six amputations were performed in the current series, and the limb salvage rate was 89%. There were nine deaths, two patients had reoccurring disease, one had lung metastasis, and all other patients had no sign of disease after surgery, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Tsagkozis reports no relevant financial disclosures. Please see the full study for list of all other authors’ financial disclosures.
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