ENDOPROSTHETIC REPLACEMENTIN PATIENTS WITH TUMORS OF BONES AND JOINTS: REVISION SURGERY

Abstract

The article analyzes complications after individual oncological endoprosthesis replacement in tumor lesions of bones and joints, which led to repeated endoprosthesis replacement. After operations of endoprosthesis replacement of bones and joints with tumor lesions, the following complications were observed: periprosthetic infection — 7.4%, aseptic instability of the stem of endoprosthesis —13.1%, destruction of the endoprosthesis structure - 2.3%, wear of polyethylene inserts — 1.7%. Revision endoprosthesis replacement due to complications after endoprosthesis replacement of bones and joints for tumors was performed in 38 (21.7%) cases. Repeated endoprosthesis replacement of knee joint was performed in 22 cases, repeated endoprosthesis replacement of hip joint was performed in 6 cases, repeated endoprosthesis replacement of elbow joint was performed in 4 cases, repeated endoprosthesis replacement of shoulder joint was performed in 3 cases, repeated endoprosthesis replacement of tibial shaft was performed in 2 cases, repeated endoprosthesis replacement of ankle joint was performed in 1 case. The factors that led to complications and repeated endoprosthesis replacement were presented. In case of an infectious complication, it was recommended to install a metal-on-cement spacer, followed by repeated endoprosthesis replacement; in case of aseptic instability of the stem of endoprosthesis, repeated endoprosthesis replacement was performed with replacement of only one (loose) component of the endoprosthesis using a long intramedullary nail or replacement of the entire endoprosthesis; in case of the destruction of endoprosthesis structure, the repeated endoprosthesis replacement of the joint was effected with replacement of the entire endoprosthesis structure; when the polyethylene inserts were worn out, the repeated endoprosthesis replacement was performed with the replacement of the polyethylene inserts. After repeated endoprosthesis replacement, repeated revision operations were performed in 10 (26.3%) cases.