6533b852fe1ef96bd12aad95
RESEARCH PRODUCT
Modular megaprosthesis reconstruction for oncological and non-oncological resection of the elbow joint
Pierluigi CuomoAntonio D'arienzoFrancesco Rosario CampoRodolfo CapannaGiovanni BeltramiAndrea PiccioliGuido ScocciantiDaniel MüllerFrancesco MuratoriFilippo Frenossubject
Malemedicine.medical_treatmentElbowComplex fractureBone tumour; Complex fracture; Distal humerus; Elbow; Modular megaprosthesis; ReconstructionProsthesis0302 clinical medicineElbow JointElbow030212 general & internal medicineRange of Motion ArticularChildGeneral Environmental ScienceAged 80 and over030222 orthopedicsPalsyBiomechanicsSoft tissueModular megaprosthesisMiddle AgedProsthesis FailureTreatment Outcomemedicine.anatomical_structureBone tumourPatient Satisfaction10046 Balgrist University Hospital Swiss Spinal Cord Injury CenterFemaleDistal humerusAdultmusculoskeletal diseasesmedicine.medical_specialtyAdolescentIntra-Articular Fractures610 Medicine & healthBone NeoplasmsProsthesis DesignProsthesis ImplantationYoung Adult03 medical and health sciences2732 Orthopedics and Sports MedicinemedicineHumansSurvival rateAgedRetrospective Studiesbusiness.industryPlastic Surgery ProceduresNeurovascular bundleSurgeryGeneral Earth and Planetary SciencesImplantReconstruction2711 Emergency Medicinebusinessdescription
Abstract Background Reconstruction of large bone defects around the elbow joint is surgically demanding due to sparse soft tissue coverage, complex biomechanics and the close proximity to neurovascular structures. Modular megaprostheses are established reconstruction tools for the elbow, but only small case series have been reported in the literature. Methods Thirty-six patients who underwent reconstruction of the elbow joint with a modular megaprosthesis were reviewed retrospectively. In 31 patients (86.1%), elbow replacement was performed after resection of a bone tumour, whereas five non-oncological patients (13.9%) underwent surgery because of a previous failed elbow reconstruction. Functional outcome, rate of complications and oncological results were considered as primary endpoints. Results The mean follow-up was 25 months. The average achieved Mayo Elbow Performance Score (MEPS) was 77.08 (range 40–95) and the average Musculoskeletal Tumor Society (MSTS) score was 22.9 (range 8–30). Six complications (16.7%) were observed: two radial palsies, one temporary radial nerve dysfunction, one ulnar palsy, one disassembling of the articular prosthesis component and one deep infection necessitating the only implant removal. The overall 5-year survival rate of the patients was poor (25.1%) because of rapid systemic progression of the oncological disease in patients with metastatic lesion. However, the 5-year survival rate of the implant was very satisfactory (93%). Conclusions Modular megaprosthesis is a reliable and effective reconstruction tool in large bone defects around the elbow joint. The complication rates are lower than seen in osteoarticular allografts and allograft-prosthesis composites while the functional outcome is equal. In palliative situations with metastatic disease involving the elbow, modular megaprosthesis enables rapid recovery and pain relief and preserves elbow function
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-10-01 |