2002 CTOS Annual Meeting Oral Presentations — Surgery

LOW COMPLICATION RATE WITH LIMB-SPARING RESECTION AND ENDOPROSTHETIC RECONSTRUCTION: SURVIVAL ANALYSIS OF 251 PATIENTS AND ANALYSIS OF 20-YEAR EXPERIENCE
[Abstract ID: 59]

Category: Surgery

Presentation: Oral

Authors: Felasfa M Wodajo¹, Kristen Kellar-Graney¹, James C Wittig¹, Robert M Henshaw¹, Martin M Malawer¹

Author Institutions: ¹Washington Cancer Institute, DC, United States

Presenter: Felasfa M Wodajo
felasfa@earthlinl.net

Correspondent: Felasfa M Wodajo
felasfa@earthlinl.net
Washington DC United States 20010
Ph: 202-877-3970
Fax: 202-877-8959

Objectives: In order to evaluate patterns of complications and prosthetic survival after endoprosthetic reconstruction for bone tumors, the authors reviewed all procedures performed over a 20-year period at a single institution.

Methods: Patients who underwent one or more procedures with a segmental endoprosthesis, except for saddle prostheses, are reported. Prosthetic failure is defined as removal of a cemented component. Kaplan-Meier survival analysis, interval to complication and the number of operations per patient are calculated.

Results: A total of 251 patients underwent surgery. Of these, 197 patients (78%) underwent only one surgery. The remaining 54 underwent a mean of 3.5 procedures.

Conclusions: Overall prosthetic survival (92.8%) has proven to be greater than most surgeons anticipated in the early days of limb-salvage surgery. At an average follow-up of 7 years, 67% (36/54) patients who required reoperation were able to retain their prostheses. All patients with soft tissue complications were salvaged with an average of 3 procedures, while 45% (5/11) of patients with deep infections were salvaged. Prosthetic failure due to mechanical complications diminished significantly from 64% (7/11) to 36% (4/11) with introduction in 1988 of modular prostheses. Meticulous attention to technique and aggressive management of soft-tissue complications leads to excellent prosthetic survival.

.