Abstract
Tumor megaprostheses are modular systems commonly used for joint reconstructions following bone resection. In the last two decades, indications on the use of modular prostheses have progressively increased even in non-cancer patients, mainly as a review of implants, in particularly favorable conditions for hip and knee and with severe bone loss. Aim of this study is to define the current indications in the use of megaprostheses as revision implant in non-cancer patients, based on the experience of a reference cancer center and the data reported in the literature.
Similar content being viewed by others
Bibliografia
Bozic KJ, Kurtz SM, Lau E et al. (2009) The epidemiology of revision total hip arthroplasty in the United States. J Bone Jt Surg Am 91(1):128–133
Kurtz S, Ong K, Lau E et al. (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Jt Surg Am 89(4):780–785
Callaghan JJ, Salvati EA, Pellicci PM et al. (1985) Results of revision for mechanical failure after cemented total hip replacement, 1979 to 1982. A two to five-year follow-up. J Bone Jt Surg Am 67(7):1074–1085
Gross AE, Allan DG, Leitch KK, Hutchison CR (1996) Proximal femoral allografts for reconstruction of bone stock in revision arthroplasty of the hip. Instr Course Lect 45:143–147
Roberson JR (1992) Proximal femoral bone loss after total hip arthroplasty. Orthop Clin North Am 23(2):291–302
Rubash HE, Sinha RK, Shanbhag AS, Kim SY (1998) Pathogenesis of bone loss after total hip arthroplasty. Orthop Clin North Am 29(2):173–186
Berry DJ, Chandler HP, Reilly DT (1991) The use of bone allografts in two-stage reconstruction after failure of hip replacements due to infection. J Bone Jt Surg Am 73(10):1460–1468
Emerson RH, Malinin TI, Cuellar AD et al. (1992) Cortical strut allografts in the reconstruction of the femur in revision total hip arthroplasty. A basic science and clinical study. Clin Orthop Relat Res 285:35–44
Kantor GS, Osterkamp JA, Dorr LD et al. (1986) Resection arthroplasty following infected total hip replacement arthroplasty. J Arthroplast 1(2):83–89
Chandler HP (1997) Reconstruction of major segmental loss of the proximal femur in revision total hip replacement. Orthopedics 20(9):801–803
Gie GA, Linder L, Ling RS et al. (1993) Impacted cancellous allografts and cement for revision total hip arthroplasty. J Bone Jt Surg Br 75(1):14–21
Haentjens P, De Boeck H, Opdecam P (1996) Proximal femoral replacement prosthesis for salvage of failed hip arthroplasty: complications in a 2–11 year follow-up study in 19 elderly patients. Acta Orthop Scand 67(1):37–42
Malkani AL, Paiso JM, Sim FH (2000) Proximal femoral replacement with megaprosthesis. Instr Course Lect 49:141–146
Cameron HU, Hu C, Vyamont D (1997) Hinge total knee replacement revisited. Can J Surg 40(4):278–283
Cameron HU, Jung YB (1990) Hinged total knee replacement: indications and results. Can J Surg 33(1):53–57
Choong PF, Sim FH, Pritchard DJ et al. (1996) Megaprostheses after resection of distal femoral tumors. A rotating hinge design in 30 patients followed for 2–7 years. Acta Orthop Scand 67(4):345–351
Hui FC, Fitzgerald RH (1980) Hinged total knee arthroplasty. J Bone Jt Surg Am 62(4):513–519
Kawai A, Muschler GF, Lane JM et al. (1998) Prosthetic knee replacement after resection of a malignant tumor of the distal part of the femur. Medium to long-term results. J Bone Jt Surg Am 80(5):636–647
Shih LY, Sim FH, Pritchard DJ et al. (1993) Segmental total knee arthroplasty after distal femoral resection for tumor. Clin Orthop Relat Res 292:269–281
Sim FH, Chao EY (1981) Hip salvage by proximal femoral replacement. J Bone Jt Surg Am 63(8):1228–1239
Parvizi J, Sim FH (2004) Proximal femoral replacements with megaprostheses. Clin Orthop Relat Res 420:169–175
Malkani AL, Settecerri JJ, Sim FH et al. (1995) Long-term results of proximal femoral replacement for non-neoplastic disorders. J Bone Jt Surg Br 77(3):351–356
Berend KR, Lombardi AV (2009) Distal femoral replacement in nontumor cases with severe bone loss and instability. Clin Orthop Relat Res 467(2):485–492
Mortazavi SM, Kurd MF, Bender B et al. (2010) Distal femoral arthroplasty for the treatment of periprosthetic fractures after total knee arthroplasty. J Arthroplast 25(5):775–780
Appleton P, Moran M, Houshian S, Robinson CM (2006) Distal femoral fractures treated by hinged total knee replacement in elderly patients. J Bone Jt Surg Br 88(8):1065–1070
Barrack RL (2001) Evolution of the rotating hinge for complex total knee arthroplasty. Clin Orthop Relat Res 392:292–299
Springer BD, Hanssen AD, Sim FH, Lewallen DG (2001) The kinematic rotating hinge prosthesis for complex knee arthroplasty. Clin Orthop Relat Res 392:283–291
Springer BD, Sim FH, Hanssen AD, Lewallen DG (2004) The modular segmental kinematic rotating hinge for nonneoplastic limb salvage. Clin Orthop Relat Res 421:181–187
Maurer SG, Baitner AC, Di Cesare PE (2000) Reconstruction of the failed femoral component and proximal femoral bone loss in revision hip surgery. J Am Acad Orthop Surg 8(6):354–363
Aribindi R, Barba M, Solomon MI et al. (1998) Bypass fixation. Orthop Clin North Am 29(2):319–329
Paprosky WG, Lawrence J, Cameron H (1990) Femoral defect classification: clinical application. Orthop Rev 19(Suppl 9):9–17
Engh GA, Ammeen DJ (1998) Classification and preoperative radiographic evaluation: knee. Orthop Clin North Am 29(2):205–217
Whittaker JP, Dharmarajan R, Toms AD (2008) The management of bone loss in revision total knee replacement. J Bone Jt Surg Br 90(8):981–987
Korim MT, Esler CNA, Ashford RU (2014) Systematic review of proximal femoral arthroplasty for non-neoplastic conditions. J Arthroplast 29(11):2117–2121
Parvizi J, Tarity TD, Slenker N et al. (2007) Proximal femoral replacement in patients with non-neoplastic conditions. J Bone Jt Surg Am 89(5):1036–1043
Al-Taki MM, Masri BA, Duncan CP, Garbuz DS (2011) Quality of life following proximal femoral replacement using a modular system in revision THA. Clin Orthop Relat Res 469(2):470–475
Gebert C, Wessling M, Götze C et al. (2010) The modular universal tumour and revision system (MUTARS®) in endoprosthetic revision surgery. Int Orthop 34(8):1261–1265
Bertani A, Helix M, Louis ML et al. (2009) Total hip arthroplasty in severe segmental femoral bone loss situations: use of a reconstruction modular stem design (JVC IX). Retrospective study of 23 cases. Orthop Traumatol Surg Res 95(7):491–497
Sewell MD, Hanna SA, Carrington RW et al. (2010) Modular proximal femoral replacement in salvage hip surgery for non-neoplastic conditions. Acta Orthop Belg 76(4):493–502
Shih S, Wang J, Hsu C (2007) Proximal femoral megaprosthesis for failed total hip arthroplasty. Chang Gung Med J 30(1):73–80
Schoenfeld AJ, Leeson MC, Vrabec GA et al. (2008) Outcomes of modular proximal femoral replacement in the treatment of complex proximal femoral fractures: a case series. Int J Surg 6(2):140–146
Colman M, Choi L, Chen A et al. (2014) Proximal femoral replacement in the management of acute periprosthetic fractures of the hip: a competing risks survival analysis. J Arthroplast 29(2):422–427
McLean AL, Patton JT, Moran M (2012) Femoral replacement for salvage of periprosthetic fracture around a total hip replacement. Injury 43(7):1166–1169
Lundh F, Sayed-Noor AS, Brosjö O, Bauer H (2014) Megaprosthetic reconstruction for periprosthetic or highly comminuted fractures of the hip and knee. Eur J Orthop Surg Traumatol 24(4):553–557
Dean BJF, Matthews JJ, Price A et al. (2012) Modular endoprosthetic replacement for failed internal fixation of the proximal femur following trauma. Int Orthop 36(4):731–734
Pour AE, Parvizi J, Slenker N et al. (2007) Rotating hinged total knee replacement: use with caution. J Bone Jt Surg Am 89(8):1735–1741
Kavanagh BF (1992) Femoral fractures associated with total hip arthroplasty. Orthop Clin North Am 23(2):249–257
Sisto DJ, Lachiewicz PF, Insall JN (1985) Treatment of supracondylar fractures following prosthetic arthroplasty of the knee. Clin Orthop Relat Res 196:265–272
Neer CS, Grantham SA, Shelton ML (1967) Supracondylar fracture of the adult femur. A study of one hundred and ten cases. J Bone Jt Surg Am 49(4):591–613
Klein GR, Parvizi J, Rapuri V et al. (2005) Proximal femoral replacement for the treatment of periprosthetic fractures. J Bone Jt Surg Am 87(8):1777–1781
Höll S, Schlomberg A, Gosheger G et al. (2012) Distal femur and proximal tibia replacement with megaprosthesis in revision knee arthroplasty: a limb-saving procedure. Knee Surg Sports Traumatol Arthrosc 20(12):2513–2518
Suzuki G, Saito S, Ishii T et al. (2011) Previous fracture surgery is a major risk factor of infection after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19(12):2040–2044
Windhager R, Schreiner M, Staats K, Apprich S (2016) Megaprostheses in the treatment of periprosthetic fractures of the knee joint: indication, technique, results and review of literature. Int Orthop (SICOT) 40:935–943
Lamagni T (2014) Epidemiology and burden of prosthetic joint infections. J Antimicrob Chemother 69(Suppl 1):5
Younger AS, Duncan CP, Masri BA, McGraw RW (1997) The outcome of two-stage arthroplasty using a custom-made interval spacer to treat the infected hip. J Arthroplast 12(6):615–623
Hsieh P, Shih C, Chang Y et al. (2004) Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Jt Surg Am 86-A(9):1989–1997
Biring GS, Kostamo T, Garbuz DS et al. (2009) Two-stage revision arthroplasty of the hip for infection using an interim articulated Prostalac hip spacer: a 10- to 15-year follow-up study. J Bone Jt Surg Br 91(11):1431–1437
Tsuchiya H, Shirai T, Nishida H et al. (2012) Innovative antimicrobial coating of titanium implants with iodine. J Orthop Sci 17(5):595–604
Hardes J, von Eiff C, Streitbuerger A et al. (2010) Reduction of periprosthetic infection with silver-coated megaprostheses in patients with bone sarcoma. J Surg Oncol 101(5):389–395
Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27
Saleh KJ, Dykes DC, Tweedie RL et al. (2002) Functional outcome after total knee arthroplasty revision: a meta-analysis. J Arthroplast 17(8):967–977
Ghazavi MT, Stockley I, Yee G et al. (1997) Reconstruction of massive bone defects with allograft in revision total knee arthroplasty. J Bone Jt Surg Am 79(1):17–25
Jones RE, Barrack RL, Skedros J (2001) Modular, mobile-bearing hinge total knee arthroplasty. Clin Orthop Relat Res 392:306–314
Jones RE, Skedros JG, Chan AJ et al. (2001) Total knee arthroplasty using the S-ROM mobile-bearing hinge prosthesis. J Arthroplast 16(3):279–287
Hillmann A, Hoffmann C, Gosheger G et al. (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 Jt Surg Am 81(4):462–468
Lombardi AV, Mallory TH, Eberle RW, Adams JB (1997) Rotating hinge prosthesis in revision total knee arthroplasty: indications and results. Surg Technol Int 6:379–382
Pacha-Vicente D, Malik A, Castellet-Feliu E, Nardi-Vilardaga J (2008) Dislocation of rotating-hinge knee prostheses with antidislocation mechanism. J Arthroplast 23(2):299–303
Wang CJ, Wang HE (2000) Early catastrophic failure of rotating hinge total knee prosthesis. J Arthroplast 15(3):387–391
Ward WG, Haight D, Ritchie P et al. (2003) Dislocation of rotating hinge total knee prostheses. A biomechanical analysis. J Bone Jt Surg Am 85-A(3):448–453
Utting MR, Newman JH (2004) Customised hinged knee replacements as a salvage procedure for failed total knee arthroplasty. Knee 11(6):475–479
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflitto di interesse
Gli autori Andrea Angelini, Alberto Guerriero, Giulia Trovarelli, Elisa Pala, Antonio Berizzi, Carlo Biz, Silvano Pierluigi Sperotto e Pietro Ruggieri dichiarano di non avere alcun conflitto di interesse.
Consenso informato e conformità agli standard etici
Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.
Human and Animal Rights
L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.
Rights and permissions
About this article
Cite this article
Angelini, A., Guerriero, A., Trovarelli, G. et al. L’uso delle megaprotesi nella chirurgia di revisione dell’arto inferiore. LO SCALPELLO 31, 282–288 (2017). https://doi.org/10.1007/s11639-017-0222-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11639-017-0222-z