Sharil, Abdul Rahim
(2008)
Functional Outcome Following Modular
Endoprosthesis Reconstruction Surgery in
Primary Bone Tumor of the Lower Limb.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
Introduction: Wide resection in Limb Salvage Surgery for primary bone tumors results in
segmental osseous defect. The optimum method for reconstruction distal femur and
proximal tibia remained controversial. Options include the use of autografts, allografts,
custom-made megaprostheses and modular endoprostheses. Endoprosthesis allows early
rehabilitation with a good long term functional outcome result. . The aim of this study is
to evaluate the functional outcome of patient in modular endoprosthetic reconstructions
surgery in the treatment of primary bone tumors of distal femur and proximal tibia of the
lower limb, by using Musculoskeletal Tumor Society scoring system.
Methods: Fifty four consecutive patients with primary bone tumor of distal femur and
proximal tibia were selected and reviewed to determine the functional outcome after wide
resection endoprosthesis reconstruction surgery by using Musculoskeletal Tumor Society
scoring system.
Results: There were 34 (63%) cases of distal femur and 20 (37%) cases of proximal tibia
bone tumor. The Primary osteosarcoma are 33 (61.1%) and stage III GCT are 20 (37%).
The mean age is 26.6±10.61. There were 12 (22.2%) patients who had met~tasis to the
lung. The mean MSTS score for both DF and PT endoprosthesis was 21.13 (70.43%),
MSTS score for DF was 21.94 (73.13%) and PT was 19.75 (65.83%) group into good to
excellent result. The infection rate was 13% (7 cases) and high in PT endoprosthesis group. The early revision rate of endoprosthesis replacement was 11.1% (6 cases) mainly
due to infection (3 cases). Infection and at site of endoprosthesis were the cause of early
failure.
Conclusion: Endoprosthesis replacement for primary bone tumors had good to excellence
MSTS score. There were no different in functional outcome after distal femur
endoprosthesis and proximal tibia endoprosthesis. The cause of early failure in our center
following endoprosthesis surgery is infection and the location of endoprosthesis
replacement which is a proximal tibia.
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