[Management of complications following tumor endoprosthetic replacement].
Komplikationsmanagement nach Tumorendoprothesen.
Arthroplasty
Bone cancer
Infection
Prosthesis loosening
Revision surgery
Journal
Der Orthopade
ISSN: 1433-0431
Titre abrégé: Orthopade
Pays: Germany
ID NLM: 0331266
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
pubmed:
28
5
2019
medline:
19
9
2019
entrez:
26
5
2019
Statut:
ppublish
Résumé
Tumor endoprostheses are available as modular systems with which bone defects can be partially reconstructed, usually close to the joints, or as a total replacement of long tubular bones. As a result of continuously improved survival times, they are used with bone tumors, skeletal metastases and, increasingly, in revision arthroplasty. Presentation of the most common complications of tumor endoprostheses and a description of their management, including treatment recommendations. The current knowledge and our own experience of complication management with the use of megaprostheses are presented. The number of tumor endoprostheses procedures is limited, so that a limited number of studies and classifications are available. Periprosthetic infections involving the soft tissues represent the most serious failure after perioperative dying and local recurrence of the tumor. Two-stage revision remains the gold standard in periprosthetic infection, even if one-stage revision is justifiable in selective indications. Periprosthetic infection and local recurrence is associated with the risk of secondary amputations. Mechanical failure can be treated more easily. Specific socket systems for proximal femoral replacement and attachment tubing allow for adequate soft tissue reconstruction, restoration of joint function, and minimize the risk of dislocation. In comparison to primary arthroplasty, the risk of failure following tumor endoprosthetic replacement is increased but is basically controllable by revision surgery.
Sections du résumé
BACKGROUND
BACKGROUND
Tumor endoprostheses are available as modular systems with which bone defects can be partially reconstructed, usually close to the joints, or as a total replacement of long tubular bones. As a result of continuously improved survival times, they are used with bone tumors, skeletal metastases and, increasingly, in revision arthroplasty.
OBJECTIVES
OBJECTIVE
Presentation of the most common complications of tumor endoprostheses and a description of their management, including treatment recommendations.
MATERIALS AND METHODS
METHODS
The current knowledge and our own experience of complication management with the use of megaprostheses are presented.
RESULTS
RESULTS
The number of tumor endoprostheses procedures is limited, so that a limited number of studies and classifications are available. Periprosthetic infections involving the soft tissues represent the most serious failure after perioperative dying and local recurrence of the tumor. Two-stage revision remains the gold standard in periprosthetic infection, even if one-stage revision is justifiable in selective indications. Periprosthetic infection and local recurrence is associated with the risk of secondary amputations. Mechanical failure can be treated more easily. Specific socket systems for proximal femoral replacement and attachment tubing allow for adequate soft tissue reconstruction, restoration of joint function, and minimize the risk of dislocation.
CONCLUSIONS
CONCLUSIONS
In comparison to primary arthroplasty, the risk of failure following tumor endoprosthetic replacement is increased but is basically controllable by revision surgery.
Identifiants
pubmed: 31127332
doi: 10.1007/s00132-019-03756-z
pii: 10.1007/s00132-019-03756-z
doi:
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
588-597Références
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