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Extracorporeally irradiated autograft‐prosthetic composite arthroplasty using AML® extensively porous‐coated stem for proximal femur reconstruction: A clinical analysis of 14 patients
Author(s) -
Chen ChengFong,
Chen WeiMing,
Cheng YuChieh,
Chiang ChaoChing,
Huang ChingKuei,
Chen TainHsiung
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21351
Subject(s) - medicine , surgery , femur , prosthesis , fixation (population genetics) , complication , arthroplasty , environmental health , population
Background and Objectives Allograft‐prosthetic composite for reconstruction of the proximal femur after tumor excision is widely used as an alternative to megaprosthesis. To achieve greater biological fixation, we employed a long‐stem prosthesis that is cemented proximally into the extracorporeally irradiated autograft and press‐fit distally into the host femur without any supplementary plate fixation of the junction instead of the standard all‐cemented technique. Methods From 1997 to 2002, 14 patients underwent proximal femur reconstruction with extracorporeally irradiated autograft‐prosthetic composite using an AML® extensively porous‐coated long stem for reconstruction of the bone defect of tumor excisions. Results At the mean follow‐up period of 65.7 months, only one patient (8.1%) developed non‐union and another died of disease before union of the junction. The remaining 12 patients (85%) achieved union at a mean of 20.3 weeks (range, 14–40 weeks) without major complication. The mean functional Enneking score was 72.1% (range, 53–93%). Conclusions These clinical results show that this reliable and satisfactory technique promotes union through compression at the host‐graft junction with weight‐bearing by leaving the distal portion of the femoral stem uncemented into the host bone. J. Surg. Oncol. 2009;100:418–422. © 2009 Wiley‐Liss, Inc.