Coaxial extendible knee equalizes limb length in children with osteogenic sarcoma

Alexandre Arkader, Dan C.M. Viola, Carol D. Morris, Patrick J. Boland, John H. Healey

Research output: Contribution to journalArticle

Abstract

We assessed our ability to achieve limb length equality (LLE) in children following limb-sparing surgery for distal femur osteogenic sarcoma using coaxial extendible prostheses in 12 children, averaging 11.6 years old at the time of tumor resection (range, 5.9-15.5 years). All but one child achieved clinical limb length equality. There were 23 extensions, averaging 3.8 extensions per patient (range, 1-5), by an average 13 mm per extension and an average total extension of 49.3 mm per patient extended. Eight children underwent revision surgery after an average of 45.1 months (range, 3-115 months). Aseptic loosening occurred more frequently among children with greater femoral diameter growth. The overall prosthetic survival was 60% at 3 years and 35% at 5 years. The survival until aseptic loosening at 3 and 5 years was 85% and 45%, respectively. Press-fit components survived longer than cemented stems. None of the devices loosened. At skeletal maturity the MSTS functional scores averaged 25. Using a coaxial extendible implant, we efficiently achieved LLE in this population. Prosthetic revision was needed frequently. Younger age and longer resection percentages were associated with shorter prosthetic survival and higher revision/aseptic loosening rates. Femoral diameter growth may contribute to loosening. Early experience with this extendible implant is promising.

Original languageEnglish (US)
Pages (from-to)60-65
Number of pages6
JournalClinical orthopaedics and related research
Issue number459
DOIs
StatePublished - Jun 2007
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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