Modular endoprosthetic replacement for proximal tibia tumor patients

Authors

  • O. Ye. Vyrva Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • I. O. Skoryk Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • V. D. Tovazhnianska Private Institution of Higher Education “Kharkiv International medical University”, Ukraine, Ukraine

DOI:

https://doi.org/10.14739/2310-1210.2021.2.224920

Keywords:

malignant bone tumors, modular endoprosthesis, proximal tibia

Abstract

The major method of malignant bone tumors treatment is surgery. The most important task of an orthopedic surgeon is to preserve an adjacent joint. Currently, there are a large number of various reconstructive surgeries, including structural bone allograft, allocomposite and modular endoprosthetics replacement.

The aim: to analyze the results of surgical treatment for proximal tibia malignant tumors using modular endoprosthesis.

Materials and methods. The results of proximal tibia (PT) modular endoprosthetic replacement in 48 patients with PT tumor lesions were evaluated. The patients were divided into two groups: I (n = 36) – tumor resection and primary modular endoprosthesis, II (n = 12) – revision modular endoprosthetic replacement due to complications. Complications were divided into oncological, mechanical and non-mechanical. The functional outcomes were measured using the MSTS and TESS scores.

Results. During the treatment, 10 (21.2 %) patients underwent myofascioplastic amputation at the middle third of the thigh: due to periprosthetic infection – 8 people and tumor recurrence – 2.

It was found that the patients got back to regular way of life on average in 2.0–2.5 months. Functional results on the MSTS score were 73 ± 12 %, on the TESS score – 74 ± 16 %, which corresponds to good functional results. Among the patients, who underwent limb salvage surgery, no tumor recurrence was detected during a follow-up period from 6 months up to 11 years.

Conclusions. The choice of surgical treatment depends on the size of tumor, its location, pathohistomorphological picture, age, presence of pathological fractures, vascular and nerve tumor invasion. The use of modern designs of PT modular tumor endoprostheses and perfect surgeries makes it possible to minimize complications.

Author Biographies

O. Ye. Vyrva, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD, DSc, Professor, Chief Medical Officer, Head of the Bone Tumor Department

I. O. Skoryk, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD student

V. D. Tovazhnianska, Private Institution of Higher Education “Kharkiv International medical University”, Ukraine

V. D., MD, PhD, Assistant of the Department of Professionally Oriented Disciplines

References

Albergo, J. I., Gaston, C. L., Aponte-Tinao, L. A., Ayerza, M. A., Muscolo, D. L., Farfalli, G. L., Jeys, L. M., Carter, S. R., Tillman, R. M., Abudu, A. T., & Grimer, R. J. (2017). Proximal Tibia Reconstruction After Bone Tumor Resection: Are Survivorship and Outcomes of Endoprosthetic Replacement and Osteoarticular Allograft Similar? Clinical Orthopaedics and Related Research, 475(3), 676-682. https://doi.org/10.1007/s11999-016-4843-y

Bates, N. A., Myer, G. D., Shearn, J. T., & Hewett, T. E. (2015). Anterior cruciate ligament biomechanics during robotic and mechanical simulations of physiologic and clinical motion tasks: a systematic review and meta-analysis. Clinical Biomechanics, 30(1), 1-13. https://doi.org/10.1016/j.clinbiomech.2014.12.006

Bus, M. P., van de Sande, M. A., Fiocco, M., Schaap, G. R., Bramer, J. A., & Dijkstra, P. D. (2017). What Are the Long-term Results of MUTARS® Modular Endoprostheses for Reconstruction of Tumor Resection of the Distal Femur and Proximal Tibia? Clinical Orthopaedics and Related Research, 475(3), 708-718. https://doi.org/10.1007/s11999-015-4644-8

Calori, G. M., Mazza, E. L., Vaienti, L., Mazzola, S., Colombo, A., Gala, L., & Colombo, M. (2016). Reconstruction of patellar tendon following implantation of proximal tibia megaprosthesis for the treatment of post-traumatic septic bone defects. Injury, 47(Suppl. 6), S77-S82. https://doi.org/10.1016/S0020-1383(16)30843-9

Donati, D., Colangeli, M., Colangeli, S., Di Bella, C., & Mercuri, M. (2008). Allograft-Prosthetic Composite in the Proximal Tibia After Bone Tumor Resection. Clinical Orthopaedics and Related Research, 466(2), 459-465. https://doi.org/10.1007/s11999-007-0055-9

Gottsauner-Wolf, F., Kotz, R., Knahr, K., Kristen, H., Ritschl, P., & Salzer, M. (1991). Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients. The Journal of Bone & Joint Surgery, 73(9), 1365-1375.

Henderson, E. R., Groundland, J. S., Pala, E., Dennis, J. A., Wooten, R., Cheong, D., Windhager, R., Kotz, R. I., Mercuri, M., Funovics, P. T., Hornicek, F. J., Temple, H. T., Ruggieri, P., & Letson, G. D. (2011). Failure Mode Classification for Tumor Endoprostheses: Retrospective Review of Five Institutions and a Literature Review. The Journal of Bone & Joint Surgery, 93(5), 418-429. https://doi.org/10.2106/JBJS.J.00834

Henderson, E. R., O'Connor, M. I., Ruggieri, P., Windhager, R., Funovics, P. T., Gibbons, C. L., Guo, W., Hornicek, F. J., Temple, H. T., & Letson, G. D. (2014). Classification of failure of limb salvage after reconstructive surgery for bone tumours: a modified system Including biological and expandable reconstructions. The Bone & Joint Journal, 96-B(11), 1436-1440. https://doi.org/10.1302/0301-620X.96B11.34747

Ichikawa, J., Matsumoto, S., Shimoji, T., Ae, K., Tanizawa, T., & Gokita, T. (2015). A new technique using mesh for extensor reconstruction after proximal tibial resection. The Knee, 22(6), 659-663. https://doi.org/10.1016/j.knee.2015.01.001

Jeys, L. M., Grimer, R. J., Carter, S. R., & Tillman, R. M. (2005). Periprosthetic Infection in Patients Treated for an Orthopaedic Oncological Condition. The Journal of Bone & Joint Surgery, 87(4), 842-849. https://doi.org/10.2106/JBJS.C.01222

Liu, B., Tan, J. C., Wang, H. L., Wu, Z., Yuan, Z. C., & Wei, C. Y. (2019). The role of mesh technology with tumor prosthesis reconstruction to reconstruct the extensor mechanism of knee joint after resection of proximal tibial tumors. Journal of Orthopaedic Surgery and Research, 14(1), Article 64. https://doi.org/10.1186/s13018-019-1105-1

Loudon, J. K. (2016). Biomechanics and pathomechanics of the patellofemoral joint. International journal of sports physical therapy, 11(6), 820-830.

Mavrogenis, A. F., Pala, E., Angelini, A., Ferraro, A., & Ruggieri, P. (2013). Proximal Tibial Resections and Reconstructions: Clinical Outcome of 225 Patients. Journal of Surgical Oncology, 107(4), 335-342. https://doi.org/10.1002/jso.23216

Pala, E., Trovarelli, G., Calabrò, T., Angelini, A., Abati, C. N., & Ruggieri, P. (2015). Survival of Modern Knee Tumor Megaprostheses: Failures, Functional Results, and a Comparative Statistical Analysis. Clinical Orthopaedics and Related Research, 473(3), 891-899. https://doi.org/10.1007/s11999-014-3699-2

Picci, P., Manfrini, M., Fabbri, N., Gambarotti, M., & Vanel, D. (Eds.). (2014). Atlas of Musculoskeletal Tumors and Tumorlike Lesions. Springer International Publishing. https://doi.org/10.1007/978-3-319-01748-8

Puchner, S. E., Kutscha-Lissberg, P., Kaider, A., Panotopoulos, J., Puchner, R., Böhler, C., Hobusch, G., Windhager, R., & Funovics, P. T. (2015). Outcome after Reconstruction of the Proximal Tibia - Complications and Competing Risk Analysis. PLOS ONE, 10(8), Article e0135736. https://doi.org/10.1371/journal.pone.0135736

Sharma, A., & Komistek, R. D. (2018). Contact Mechanics of the Human Knee. In W. N. Scott, D. R. Diduch, R. Iorio, & J. W. Long (Eds.), Insall & Scott Surgery of the Knee (6th ed., Vol. 1, pp. 329-337.e1). Elsevier.

Sigal, I. R., Grande, D. A., Dines, D. M., Dines, J., & Drakos, M. (2016). Biologic and Tissue Engineering Strategies for Tendon Repair. Regenerative Engineering and Translational Medicine, 2(3-4), 107-125. https://doi.org/10.1007/s40883-016-0019-2

Smolle, M. A., Andreou, D., Tunn, P. U., & Leithner, A. (2019). Advances in tumour endoprostheses: a systematic review. EFORT Open Reviews, 4(7), 445-459. https://doi.org/10.1302/2058-5241.4.180081

Snedeker, J. G., & Foolen, J. (2017). Tendon injury and repair - A perspective on the basic mechanisms of tendon disease and future clinical therapy. Acta Biomaterialia, 63, 18-36. https://doi.org/10.1016/j.actbio.2017.08.032

Summers, S. H., Zachwieja, E. C., Butler, A. J., Mohile, N. V., & Pretell-Mazzini, J. (2019). Proximal Tibial Reconstruction After Tumor Resection: A Systematic Review of the Literature. JBJS Reviews, 7(7), e1. https://doi.org/10.2106/JBJS.RVW.18.00146

Urakawa, H., Yonemoto, T., Matsumoto, S., Takagi, T., Asanuma, K., Watanuki, M., Takemoto, A., Naka, N., Matsumoto, Y., Kawai, A., Kunisada, T., Kubo, T., Emori, M., Hiraga, H., Hatano, H., Tsukushi, S., Nishida, Y., Akisue, T., Morii, T., Takahashi, M., … Ozaki, T. (2018). Clinical outcome of primary giant cell tumor of bone after curettage with or without perioperative denosumab in Japan: from a questionnaire for JCOG 1610 study. World Journal of Surgical Oncology, 16(1), Article 160. https://doi.org/10.1186/s12957-018-1459-6

Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta Biomedica, 88(Suppl. 2), 6-16. https://doi.org/10.23750/abm.v88i2-S.6507

Wu, F., Nerlich, M., & Docheva, D. (2017). Tendon injuries: Basic science and new repair proposals. EFORT Open Reviews, 2(7), 332-342. https://doi.org/10.1302/2058-5241.2.160075

Vyrva, O. Ye. (2014). Suchasnyi pidkhid do likuvannia zloiakisnykh kistkovykh pukhlyn (ohliad literatury) (Ch. 2) [The current approach to treatment of malignant bone tumors (literature review) (part 2)]. Ortopediya, travmatologiya i protezirovanie, (1), 117-126. https://doi.org/10.15674/0030-598720141117-126 [in Ukrainian].

Vyrva, O. Ye., Ashukinа, N. O., Skoryk, I. O., & Danishchuk, Z. M. (2020). Struktura zv’iazky nakolinka shchuriv za umov yii fiksatsii na rizni poverkhni implantativ [The structure of patella ligament of rats when it is fixed on different implants surfaces]. Ortopediya, travmatologiya i protezirovanie, (1), 78-87. https://doi.org/10.15674/0030-59872020178-87 [in Ukrainian].

Vyrva, O. Ye., & Skoryk, I. O. (2019). Modulne endoprotezuvannia proksymalnoho viddilu velykohomilkovoi kistky v razi hihantoklitynnoi pukhlyny [Modular endoprosthetics proximal tibia in case of giant cell tumor]. Ortopediya, travmatologiya i protezirovanie, (1), 72-77. https://doi.org/10.15674/0030-59872019172-77 [in Ukrainian].

Vyrva, O. E., Golovina, Ya. A., & Malyk, R. V. (2015). Allokompozitnoe endoprotezirovanie pri khirurgicheskom lechenii patsientov so zlokachestvennymi opukholyami dlinnykh kostei (obzor literatury) [Allograft-prosthesis composite for surgical treatment in patients with malignant tumors of the long bones (review)]. Ortopediya, travmatologiya i protezirovanie, (2), 120-125. https://doi.org/10.15674/0030-598720152120-125 [in Russian].

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Published

2021-04-16

How to Cite

1.
Vyrva OY, Skoryk IO, Tovazhnianska VD. Modular endoprosthetic replacement for proximal tibia tumor patients. Zaporozhye Medical Journal [Internet]. 2021Apr.16 [cited 2024Jul.27];23(2):242-9. Available from: http://zmj.zsmu.edu.ua/article/view/224920

Issue

Vol. 23 No. 2 (2021)

Section

Original research

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