Posters— Surgical Treatment of Sarcomas

SURVIVORSHIP OF SEGMENTAL PROSTHETIC ARTHROPLASTY FOR LIMB SALVAGE FOLLOWING BONE SARCOMA RESECTIONS

Yasko AW, Lin PP, Weber KL (The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA 77030)

Introduction: Prosthetic arthroplasty is the most common method of reconstruction of segmental bone defects following resection of bone sarcomas. The purpose of this study was to determine the survivorship of the reconstructions in short- and long-term follow-up.

Methods: A retrospective study was performed on all patients diagnosed with a bone sarcoma between 1980 and 1995 who were treated with a limb-sparing osteoarticular resection and prosthetic arthroplasty reconstruction. Prosthetic survival was calculated with endpoints of analysis based on any event, any prosthesis-related event and aseptic loosening of the prosthesis which led to prosthetic revision, removal or limb amputation.

Results: A total of 237 reconstructions were performed involving the distal femur (n=111), proximal tibia (n=43), proximal humerus (n=47), and proximal femur (n=36). All implants were fixed with polymethylmethacrylate cement. 174/237 (73%) did not require a reoperation at last follow-up evaluation. Early complications (within one year postoperatively) developed in fewer than 2% of patients. Aseptic loosening occurred late and accounted for the majority of events resulting in prosthetic failures (51%). Amputations were performed in 10% of patients prosthesis-related complications or tumor recurrence. Prosthetic Arthroplasty Survival (prosthetic-related events)

Conclusion: The early outcome of prosthetic arthroplasty was extremely favorable supporting this method of reconstruction following excision of high-grade bone sarcoma. Long-term survival of prosthetic arthroplasty can be anticipated following tumor resection about the shoulder and hip. Aseptic loosening continues to be the primary cause of prosthetic failure, especially about the knee.