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Clinical outcomes of Kyocera Modular Limb Salvage system after resection of bone sarcoma of the distal part of the femur: the Japanese Musculoskeletal Oncology Group study

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Abstract

Purpose

The Japanese Musculoskeletal Oncology Group have developed an original prosthesis called the Kyocera Modular Limb Salvage system (KMLS system). This prosthesis has a semi-rotating hinge joint and is particularly designed for people with an Asian body type. The metallic parts of the prosthesis are made entirely of titanium alloy. The purpose of this study is to evaluate the clinical outcomes of treatment using this system following tumour resection of primary bone sarcoma of the distal femur.

Methods

Between 2002 and 2010, 82 patients with primary bone sarcomas of the distal femur were treated. Seventeen patients underwent stem cementation, while 65 patients were treated with cementless prostheses. The mean follow-up period after surgery was 61 months.

Results

Complications were observed in 28 of the 82 patients. Forty-one complications occurred in these 28 patients. Thirteen prostheses (16 %) required revision surgery due to complications, including five cases of stem breakage, three deep infections, three cases of aseptic loosening, one case of displacement of the shaft cap and one case of breakage of the tibial tray. The five-year overall prosthetic survival rate was 80.0 %. Four of the 82 patients underwent subsequent amputation due to local recurrence. The five-year limb salvage rate was 94.5 %. The mean function score according to the scoring system of the Musculoskeletal Tumour Society was 21.8 points (72.5 %).

Conclusions

Although further follow-up is required to determine the performance, this prosthesis is considered to be satisfactory for reconstruction of the distal femur after resection of bone sarcoma.

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References

  1. Torbert JT, Fox EJ, Hosalkar HS, Ogilvie CM, Lackman RD (2005) Endoprosthetic reconstructions. Results of long-term follow up of 139 patients. Clin Orthop Relat Res 438:51–59

    Article  PubMed  Google Scholar 

  2. Dofman HD, Czerniak B (1988) General considerations. In: Dorfman HD, Czerniak B (eds) Bone Tumors. CV Mosby, St Louis, pp 1–33

    Google Scholar 

  3. Matsumine A, Ueda T, Sugita T et al (2011) Japanese musculoskeletal oncology group. Clinical outcomes of the KYOCERA Physio Hinge total knee system type III after resection of a bone and soft tissue tumor of the distal part of the femur. J Surg Oncol 103:257–263

    Article  PubMed  Google Scholar 

  4. Horowitz SM, Lane JM, Otis JC, Healy JH (1991) Prosthetic arthroplasty of the knee after resection of a sarcoma in the proximal end of the tibia: a report of sixteen cases. J Bone Joint Surg Am 73-A:286–293

    Google Scholar 

  5. Unwin PS, Cannon SR, Grimer RJ et al (1996) Aseptic loosening in cemented custom-made replacements for bone tumors of the lower limb. J Bone Joint Surg Br 78-B:5–13

    Google Scholar 

  6. Ereth MH, Weber JG, Abel MD et al (1992) Cemented versus noncemented total hip arthroplasty: embolism, hemodymanics, and intrapulmonary shunting. Mayo Clin Proc 67:1066–1074

    Article  PubMed  CAS  Google Scholar 

  7. Francis CW, Marder VJ, Evarts CM (1986) Lower risk of thromboembolic disease after total hip replacement with non-cemented than with cemented prostheses. Lancet 1:769–771

    Article  PubMed  CAS  Google Scholar 

  8. Kim YH, Suh JS (1988) Low incidence of deep-vein thrombosis after cementless total hip replacement. J Bone Joint Surg Am 70:878–882

    PubMed  CAS  Google Scholar 

  9. Enneking WF, Spanier SS, Goodman MA (1980) A system for surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 153:106–120

    PubMed  Google Scholar 

  10. Enneking WF, Dunham W, Gebhardt MC et al (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 286:241–246

    PubMed  Google Scholar 

  11. Rougraff BT, Simon MA, Kneisl JS, Greenberg DB, Mankin HJ (1994) Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study. J Bone Joint Surg Am 76:649–656

    PubMed  CAS  Google Scholar 

  12. Henderson ER, Pepper AM, Marulanda G, Binitie OT, Cheong D, Letson GD (2012) Outcome of lower-limb preservation with an expandable endoprosthesis after bone tumor resection in children. J Bone Joint Surg Br 94:537–547

    Article  Google Scholar 

  13. Myers GJC, Abudu AT, Tillman RM, Grimer RJ (2007) Endoprosthetic replacement of the distal femur for bone tumours. Long-term results. J Bone Joint Surg 89:521–526

    Article  CAS  Google Scholar 

  14. Mittermeyer F, Krepler P, Dominkus M et al (2001) Long-term follow up of uncemented tumor prostheses for the lower extremity. Clin Orthop Relat Res 388:167–177

    Article  Google Scholar 

  15. Cappana R, Morris HG, Campanacci D, Del Ben M, Campanacci M (1994) Modular uncemented prosthetic reconstruction after resection of tumours of the distal femur. J Bone Joint Surg Br 76-B:178–186

    Google Scholar 

  16. Plotz W, Rechl H, Burgkart R et al (2002) Limb salvage with tumor endoprostheses for malignant tumors of the knee. Clin Orthop Relat Res 405:207–215

    Article  PubMed  Google Scholar 

  17. Gosheger G, Gebert C, Ahrens H, Streibuerger A, Winkelmann W, Hardes J (2006) Endoprosthetic reconstruction in 250 patients with sarcoma. Clin Orthop Relat Res 450:164–171

    Article  PubMed  Google Scholar 

  18. Hardes J, Gebert C, Schwappach A et al (2006) Characteristics and outcome of infections associated with tumor endoprostheses. Arch Orthop Trauma Surg 126:289–296

    Article  PubMed  CAS  Google Scholar 

  19. Hillmann A, Hoffmann C, Gosheger G, Krakau H, Winkelmann W (1999) Malignant tumor of the distal part of the femur or the proximal part of the tibia: endoprosthetic replacement or rotationplasty: functional outcome and quality-of-life measurements. J Bone Joint Surg Am 81-A:462–468

    Google Scholar 

Download references

Acknowledgments

We thank the following members of the JMOG for their cooperation with collection of clinical data of patients: H. Maehara, H. Kakizaki, T. Minamizaki, K. Numamoto, R. Yokoyama, S. Kakunaga, N. Naka, K. Aono, F. Nakayama, N. Hashimoto, S. Abe, K. Kikuta, K.Oshima, H Futani, H. Obata K. Ihara and T. Goto.

Conflict of interest statement

We declare that we have no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan

    Tomoki Nakamura, Akihiko Matsumine, Atsumasa Uchida & Akihiro Sudo

  2. Division of Orthopaedic Surgery, National Cancer Center Hospital, Tokyo, Japan

    Akira Kawai

  3. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshihiro Nishida

  4. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine and Dental Science, Okayama, Japan

    Toshiyuki Kunisada

  5. Department of Orthopaedic Surgery, Osaka General Medical Center, Osaka, Japan

    Nobuhito Araki

  6. Department of Orthopaedic Surgery, Aichi Cancer Center, Nagoya, Japan

    Hideshi Sugiura

  7. Department of Orthopaedic Surgery, Nagasaki University Hospital, Nagasaki, Japan

    Masato Tomita

  8. Department of Orthopaedic Surgery, Graduate School of Medical and Dental Science, Kagoshima University, Kagoshima, Japan

    Masahiro Yokouchi

  9. Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan

    Takafumi Ueda

Authors
  1. Tomoki Nakamura
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  2. Akihiko Matsumine
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  3. Atsumasa Uchida
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  4. Akira Kawai
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  5. Yoshihiro Nishida
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  6. Toshiyuki Kunisada
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  7. Nobuhito Araki
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  8. Hideshi Sugiura
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  9. Masato Tomita
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  10. Masahiro Yokouchi
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  11. Takafumi Ueda
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  12. Akihiro Sudo
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Corresponding author

Correspondence to Akihiko Matsumine.

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Nakamura, T., Matsumine, A., Uchida, A. et al. Clinical outcomes of Kyocera Modular Limb Salvage system after resection of bone sarcoma of the distal part of the femur: the Japanese Musculoskeletal Oncology Group study. International Orthopaedics (SICOT) 38, 825–830 (2014). https://doi.org/10.1007/s00264-013-2151-7

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  • DOI: https://doi.org/10.1007/s00264-013-2151-7

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