Extended distal femur resection: Megaprosthesis with telescopic bone allograft augmentation versus total femur prosthesis

Author:

Bruschi Alessandro12ORCID,Cevolani Luca1ORCID,Minerba Andrea12,Conversano Davide2,Falzetti Luigi12,Pasini Stefano12ORCID,Donati Davide M.12

Affiliation:

1. Orthopaedic Oncology Unit IRCCS Istituto Ortopedico Rizzoli Bologna Italy

2. Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy

Abstract

AbstractBackground and ObjectiveOncological distal femur resections can leave a proximal femur too short to host a stem. Reconstructive techniques are then challenging. The purpose of the study is to compare implant survival, complication rate and MSTS of two different options.MethodsWe retrospectively divided 33 patients with primary bone tumours of distal femur in Group 1 (16 patients reconstructed with knee megaprosthesis with proximal bone augmentation, APC) and Group 2 (17 patients reconstructed with total femur prosthesis, TFP). Less than 12 cm of remaining proximal femur were planned for all resections.ResultsMSTS score at 2 years is 25 ± 5 for Group 1 and 19 ± 7 for Group 2 (confidence interval [C.I.] 95%, p = 0.02). At 5 years it is 27 ± 2 for Group 1 and 22 ± 6 for Group 2 (C.I. 95%, p = 0.047). Failure and complication rates are lower for Group 1, but no statistical significance was reached. In APC reconstruction, union at the host‐allograft junction was achieved in 16 out of 16 patients using the telescopic bone augmentation technique.ConclusionsAPC provides higher functional results compared to TFP after extended distal femur resection. In APC reconstruction, telescopic augmentation is excellent for achieving union at the host‐allograft junction.

Publisher

Wiley

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