The risk for complications and reoperations with the use of mega prostheses in bone reconstructions
Abstract Background Despite a relatively high risk for complications and reoperations, mega prostheses are considered a useful method for reconstruction of bone defects after tumour resections. The total number of reoperations has not previously been described, and little is known about the complica...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02749-z |
| _version_ | 1811300385033289728 |
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| author | Christina Berger Sofia Larsson Peter Bergh Helena Brisby David Wennergren |
| author_facet | Christina Berger Sofia Larsson Peter Bergh Helena Brisby David Wennergren |
| author_sort | Christina Berger |
| collection | DOAJ |
| description | Abstract Background Despite a relatively high risk for complications and reoperations, mega prostheses are considered a useful method for reconstruction of bone defects after tumour resections. The total number of reoperations has not previously been described, and little is known about the complication rate of mega prostheses used for other indications than primary bone tumours. Questions/purposes The current retrospective observational study aimed to describe the patient population treated with mega prostheses at Sahlgrenska University Hospital, Sweden, during 14 consecutive years, reports the complications leading to reoperation and the number and type of reoperations for different kinds of complications, and reports on implant survival. Methods All patients treated with a mega prosthesis, regardless of surgical indication and anatomical location, at Sahlgrenska University Hospital during the period 2006–2019 were identified. The medical records for all patients were reviewed. Data regarding age, sex, diagnosis, site of disease, bone resection length, chemotherapeutical treatment and postoperative complications including infections and oncological outcome, were collected and evaluated. Results One hundred and fourteen patients treated with 116 mega prostheses were included in the study. The predominant indication for primary surgery with a mega prosthesis was sarcoma of either bone or soft tissue (53.5% of the patients). In total 51 prostheses (44%) did not require any reoperation after the primary surgery. The most common reason for reoperation was infection (22%) followed by soft tissue failure (13%). The risk for prosthetic infection was significantly higher in the group of patients operated due to sarcoma compared with all other indications for surgery regardless of surgical site (p = 0.004). Conclusion The study reveals a total reoperation rate of 56% after reconstructive surgery using mega prostheses. Despite the high reoperation rates, at the end of the study period, 83% of the patients had still a functioning prosthesis. Therefore, the use of mega prostheses can be considered a reliable method for reconstruction of large bone defects in selected patients. Level of Evidence Level IV, therapeutic study. |
| first_indexed | 2024-04-13T06:50:34Z |
| format | Article |
| id | doaj.art-85fb6cc2a1a44264ac5d9da00b43620a |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-13T06:50:34Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-85fb6cc2a1a44264ac5d9da00b43620a2022-12-22T02:57:25ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-10-0116111010.1186/s13018-021-02749-zThe risk for complications and reoperations with the use of mega prostheses in bone reconstructionsChristina Berger0Sofia Larsson1Peter Bergh2Helena Brisby3David Wennergren4Institute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgDepartment of Orthopaedics, Sahlgrenska University HospitalInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgInstitute of Clinical Sciences, Sahlgrenska Academy, University of GothenburgAbstract Background Despite a relatively high risk for complications and reoperations, mega prostheses are considered a useful method for reconstruction of bone defects after tumour resections. The total number of reoperations has not previously been described, and little is known about the complication rate of mega prostheses used for other indications than primary bone tumours. Questions/purposes The current retrospective observational study aimed to describe the patient population treated with mega prostheses at Sahlgrenska University Hospital, Sweden, during 14 consecutive years, reports the complications leading to reoperation and the number and type of reoperations for different kinds of complications, and reports on implant survival. Methods All patients treated with a mega prosthesis, regardless of surgical indication and anatomical location, at Sahlgrenska University Hospital during the period 2006–2019 were identified. The medical records for all patients were reviewed. Data regarding age, sex, diagnosis, site of disease, bone resection length, chemotherapeutical treatment and postoperative complications including infections and oncological outcome, were collected and evaluated. Results One hundred and fourteen patients treated with 116 mega prostheses were included in the study. The predominant indication for primary surgery with a mega prosthesis was sarcoma of either bone or soft tissue (53.5% of the patients). In total 51 prostheses (44%) did not require any reoperation after the primary surgery. The most common reason for reoperation was infection (22%) followed by soft tissue failure (13%). The risk for prosthetic infection was significantly higher in the group of patients operated due to sarcoma compared with all other indications for surgery regardless of surgical site (p = 0.004). Conclusion The study reveals a total reoperation rate of 56% after reconstructive surgery using mega prostheses. Despite the high reoperation rates, at the end of the study period, 83% of the patients had still a functioning prosthesis. Therefore, the use of mega prostheses can be considered a reliable method for reconstruction of large bone defects in selected patients. Level of Evidence Level IV, therapeutic study.https://doi.org/10.1186/s13018-021-02749-zMega prosthesesOrthopaedic oncologyBone reconstructionComplicationsBone tumours |
| spellingShingle | Christina Berger Sofia Larsson Peter Bergh Helena Brisby David Wennergren The risk for complications and reoperations with the use of mega prostheses in bone reconstructions Journal of Orthopaedic Surgery and Research Mega prostheses Orthopaedic oncology Bone reconstruction Complications Bone tumours |
| title | The risk for complications and reoperations with the use of mega prostheses in bone reconstructions |
| title_full | The risk for complications and reoperations with the use of mega prostheses in bone reconstructions |
| title_fullStr | The risk for complications and reoperations with the use of mega prostheses in bone reconstructions |
| title_full_unstemmed | The risk for complications and reoperations with the use of mega prostheses in bone reconstructions |
| title_short | The risk for complications and reoperations with the use of mega prostheses in bone reconstructions |
| title_sort | risk for complications and reoperations with the use of mega prostheses in bone reconstructions |
| topic | Mega prostheses Orthopaedic oncology Bone reconstruction Complications Bone tumours |
| url | https://doi.org/10.1186/s13018-021-02749-z |
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