The early results of joint-sparing proximal tibial replacement for primary bone tumours, using extracortical plate fixation

B G I Spiegelberg, M D Sewell, W J S Aston, G W Blunn, R Pollock, S R Cannon, T W R Briggs

Research output: Contribution to journalArticlepeer-review

Abstract

This paper describes the preliminary results of a proximal tibial endoprosthesis which spares the knee joint and enables retention of the natural articulation by replacing part of the tibial metaphysis and diaphysis. In eight patients who had a primary malignant bone tumour of the proximal tibia, the distal stem, which had a hydroxyapatite-coated collar to improve fixation, was cemented into the medullary canal. The proximal end had hydroxyapatite-coated extracortical plates which were secured to the remaining proximal tibial metaphysis using cortical screws. The mean age of the patients at operation was 28.9 years (8 to 43) and the mean follow-up was for 35 months (4 to 48). The mean Musculoskeletal Tumour Society score was 79% (57% to 90%), the mean Oxford Knee score was 40 points of 48 (36 to 46) and the mean knee flexion was 112 degrees (100 degrees to 120 degrees). In one patient, revision to a below-knee amputation through the prosthesis was required because of recurrence of the tumour. Another patient sustained a periprosthetic fracture which healed with a painful malunion. This was revised to a further endoprosthesis which replaced the knee. In the remaining six patients the prosthesis allowed preservation of the knee joint with good function and no early evidence of loosening. Further follow-up is required to assess the longevity of these prostheses.

Original languageEnglish
Pages (from-to)1373-7
Number of pages5
JournalJournal of Bone and Joint Surgery - British Volume
Volume91
Issue number10
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Adolescent
  • Adult
  • Arthroplasty, Replacement
  • Biocompatible Materials
  • Bone Neoplasms
  • Bone Plates
  • Child
  • Female
  • Humans
  • Knee Joint
  • Limb Salvage
  • Male
  • Prosthesis Design
  • Prosthesis Implantation
  • Radiography
  • Tibia
  • Time Factors
  • Treatment Outcome
  • Young Adult

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