Stanmore custom-made extendible distal femoral replacements. Clinical experience in children with primary malignant bone tumours

Oliver S. Schindler*, Stephen R. Cannon, Timothy W. R. Briggs, Gordon W. Blunn

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    Abstract

    The use of extendible distal femoral replacements is a relatively new treatment alternative for malignant bone tumours in growing individuals. Although their appearance was widely appreciated, questions about functional practicality and longevity remain unclear. With longer follow-up, advantages of immediate functional restoration and beneficial psychological aspects seem to be overshadowed by an increase in complications such as aseptic loosening, infection or prosthetic failure. We have reviewed 18 children with such tumours who were treated between 1983 and 1990 by custom-made Stanmore extendible distal femoral replacements. Four died from metastatic disease within 2.5 years of operation and two required amputation for local recurrence or chronic infection. The remaining 12 patients were followed for a mean of 8.7 years (6 to 13.2). A mean total lengthening of 5.2 cm was achieved, requiring, on average, 4.3 operations. Using the Musculoskeletal Tumor Society rating score the functional result at review was, on average, 77% of the expected normal function, with seven patients achieving ≤ 80%. Revision of the prosthesis was required in ten patients, in six for aseptic loosening, at a mean of 6.2 years after the initial procedure.

    Original languageEnglish
    Pages (from-to)927-937
    Number of pages11
    JournalJournal of Bone and Joint Surgery - Series B
    Volume79
    Issue number6
    Publication statusPublished - 1 Dec 1997

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