TY - JOUR
T1 - Coaxial extendible knee equalizes limb length in children with osteogenic sarcoma
AU - Arkader, Alexandre
AU - Viola, Dan C.M.
AU - Morris, Carol D.
AU - Boland, Patrick J.
AU - Healey, John H.
PY - 2007/6
Y1 - 2007/6
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=34249950245&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34249950245&partnerID=8YFLogxK
U2 - 10.1097/BLO.0b013e3180514c37
DO - 10.1097/BLO.0b013e3180514c37
M3 - Article
C2 - 17438477
AN - SCOPUS:34249950245
SN - 0009-921X
VL - 459
SP - 60
EP - 65
JO - Clinical orthopaedics and related research
JF - Clinical orthopaedics and related research
ER -