Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis
Background: The purpose of this study was to evaluate the implant survival, functional score and complications of intercalary endoprostheses implanted for metastatic involvement of the femoral and humeral diaphysis. Methods: The selected group covered patients with bone metastasis who were surgicall...
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| Format: | Article |
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MDPI AG
2022-05-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/5/284 |
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| author | Michal Mahdal Lukáš Pazourek Vasileios Apostolopoulos Dagmar Adámková Krákorová Iva Staniczková Zambo Tomáš Tomáš |
| author_facet | Michal Mahdal Lukáš Pazourek Vasileios Apostolopoulos Dagmar Adámková Krákorová Iva Staniczková Zambo Tomáš Tomáš |
| author_sort | Michal Mahdal |
| collection | DOAJ |
| description | Background: The purpose of this study was to evaluate the implant survival, functional score and complications of intercalary endoprostheses implanted for metastatic involvement of the femoral and humeral diaphysis. Methods: The selected group covered patients with bone metastasis who were surgically treated with an intercalary endoprosthesis between 2012 and 2021. The functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system, and complications were evaluated by using the failure classification for prosthetics designed by Henderson. Results: The mean follow-up was 29.8 months. In our group of 25 patients with 27 intercalary endoprostheses (18 femurs, 9 humeri), there were 7 implant-related complications (25.9%), which were more common on the humerus (4 cases, 44.4%) than on the femur (3 cases, 16.7%). Only type II failure—aseptic loosening (5 cases, 18.5%)—and type III failure—structural failure (2 cases, 7.4%)—occurred. There was a significantly higher risk of aseptic loosening of the endoprosthesis in the humerus compared with that in the femur (odds ratio 13.79, 95% confidence interval 1.22–151.05, <i>p</i> = 0.0297). The overall cumulative implant survival was 92% 1 year after surgery and 72% 5 years after surgery. The average MSTS score was 82%. The MSTS score was significantly lower (<i>p</i> = 0.008) in the humerus (75.9%) than in the femur (84.8%). Conclusions: The resection of bone metastases and replacement with intercalary endoprosthesis has excellent immediate functional results with an acceptable level of complications in prognostically favourable patients. |
| first_indexed | 2024-03-10T03:04:08Z |
| format | Article |
| id | doaj.art-b0f452dea6804d71a803eace9ce6dafd |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T03:04:08Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-b0f452dea6804d71a803eace9ce6dafd2023-11-23T10:37:17ZengMDPI AGCurrent Oncology1198-00521718-77292022-05-012953519353010.3390/curroncol29050284Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral DiaphysisMichal Mahdal0Lukáš Pazourek1Vasileios Apostolopoulos2Dagmar Adámková Krákorová3Iva Staniczková Zambo4Tomáš Tomáš5First Department of Orthopedic Surgery, St. Anne’s University Hospital, 65691 Brno, Czech RepublicFirst Department of Orthopedic Surgery, St. Anne’s University Hospital, 65691 Brno, Czech RepublicFirst Department of Orthopedic Surgery, St. Anne’s University Hospital, 65691 Brno, Czech RepublicClinic of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 60200 Brno, Czech RepublicFaculty of Medicine, Masaryk University, 60177 Brno, Czech RepublicFirst Department of Orthopedic Surgery, St. Anne’s University Hospital, 65691 Brno, Czech RepublicBackground: The purpose of this study was to evaluate the implant survival, functional score and complications of intercalary endoprostheses implanted for metastatic involvement of the femoral and humeral diaphysis. Methods: The selected group covered patients with bone metastasis who were surgically treated with an intercalary endoprosthesis between 2012 and 2021. The functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system, and complications were evaluated by using the failure classification for prosthetics designed by Henderson. Results: The mean follow-up was 29.8 months. In our group of 25 patients with 27 intercalary endoprostheses (18 femurs, 9 humeri), there were 7 implant-related complications (25.9%), which were more common on the humerus (4 cases, 44.4%) than on the femur (3 cases, 16.7%). Only type II failure—aseptic loosening (5 cases, 18.5%)—and type III failure—structural failure (2 cases, 7.4%)—occurred. There was a significantly higher risk of aseptic loosening of the endoprosthesis in the humerus compared with that in the femur (odds ratio 13.79, 95% confidence interval 1.22–151.05, <i>p</i> = 0.0297). The overall cumulative implant survival was 92% 1 year after surgery and 72% 5 years after surgery. The average MSTS score was 82%. The MSTS score was significantly lower (<i>p</i> = 0.008) in the humerus (75.9%) than in the femur (84.8%). Conclusions: The resection of bone metastases and replacement with intercalary endoprosthesis has excellent immediate functional results with an acceptable level of complications in prognostically favourable patients.https://www.mdpi.com/1718-7729/29/5/284bone neoplasmmetastasisdiaphysis of long bonesintercalary endoprosthesis |
| spellingShingle | Michal Mahdal Lukáš Pazourek Vasileios Apostolopoulos Dagmar Adámková Krákorová Iva Staniczková Zambo Tomáš Tomáš Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis Current Oncology bone neoplasm metastasis diaphysis of long bones intercalary endoprosthesis |
| title | Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis |
| title_full | Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis |
| title_fullStr | Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis |
| title_full_unstemmed | Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis |
| title_short | Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis |
| title_sort | outcomes of intercalary endoprostheses as a treatment for metastases in the femoral and humeral diaphysis |
| topic | bone neoplasm metastasis diaphysis of long bones intercalary endoprosthesis |
| url | https://www.mdpi.com/1718-7729/29/5/284 |
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