2002 CTOS Annual Meeting Oral Presentations — Surgery

SURVIVORSHIP ANALYSIS OF 141 MODULAR METALLIC ENDOPROSTHESES
[Abstract ID: 26]

Category: Surgery

Presentation: Oral

Authors: Erik N. Zeegen¹, Luis Aponte¹, Francis J. Hornicek¹, Mark C. Gebhardt¹, Henry J. Mankin¹

Author Institutions: ¹Massachusetts General Hospital, MA, United States

Presenter: Mark C. Gebhardt
mgebhardt@partners.org

Correspondent: Erik N. Zeegen
ezeegen_00@yahoo.com
Boston MA United States 02114
Ph: (617) 724-3700
Fax: (617) 726-6823

Objectives: To evaluate the survival rates and clinical results of modular endoprostheses in patients who have had resections for musculoskeletal tumors and some non-tumorous conditions.

Methods: We retrospectively reviewed the records of 141 patients in whom a modular endoprosthesis was implanted over the past 8 years. Statistical data was compiled using Kaplan-Meier survival analysis and a multivariate regression analysis was performed to identify independent risk factors. Failure was defined as need for revision of the majority of the prosthetic components or complete removal of the implant. Clinical results were graded according to a scoring system previously reported.

Results: There were 67 males and 74 females. The average age at the time of surgery was 48.9 years. There were 13 failures yielding an overall implant survival of 91%. Based on Kaplan-Meier estimates, the endoprosthetic survival rate was 88% at 3 years and 76% at 5 years; per location, it was 100% for proximal humerus, 100% for proximal femur, 87% for modular knees, and 53% for total femoral implants at 3 years (p = 0.03). The failure rate of failed allografts converted to an endoprosthesis was 18% versus 6% for primary endoprostheses (p = 0.08). However, multivariate analysis showed that only location, infection, and loosening were independent risk factors for prosthesis failure. Clinical scores were 74% good-excellent and 26% fair-poor. Ten patients died (9 of metastatic disease, 1 from peri-operative complications).

Conclusions: We feel that our experience, albeit short in follow-up, is similar to other endoprosthesis survivorship reports in the literature at early time points.