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Megaprosthesis versus Condyle-sparing Intercalary Allograft: Distal Femoral Sarcoma

  • Symposium: Selected Papers Presented at the 2008 Meeting of the Musculoskeletal Tumor Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Although functionally appealing in preserving the native knee, the condyle-sparing intercalary allograft of the distal femur may be associated with a higher risk of tumor recurrence and endoprosthetic replacement for malignant distal femoral bone tumors. We therefore compared the risk of local tumor recurrence between patients in these two types of reconstruction groups. We retrospectively reviewed 85 patients (mean age, 22 years; range, 4–82 years), 38 (45%) of whom had a condyle-sparing allograft and 47 (55%) of whom had endoprostheses. The minimum followup for both groups was 2 years (mean, 7 years; range, 2–19 years). Local recurrences occurred in 11% (five of 47) of the patients having implants versus 18% (seven of 38) of the patients having allografts. Using time to local recurrence as an end point, the Kaplan-Meier survivorship of the implant group was similar to that of the condyle-sparing allograft group at 2, 5, and 10 years (93% versus 87% at 2 years, 87% versus 81% at 5 years, and 87% versus 81% at 10 years, respectively). The condyle-sparing allograft procedure offers the potential advantage of retaining the native knee in a young patient population while incurring no greater risk of local recurrence as those offered the endoprosthetic procedure.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Thomas Scharschmidt, MD, and Jedediah White for their assistance in preparing the manuscript for publication.

Author information

Authors and Affiliations

  1. William Beaumont Hospital, Royal Oak, MI, USA

    Melissa N. Zimel MD

  2. Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Box 356500, 959 NE Pacific Street, Seattle, WA, 98195-6500, USA

    Amy M. Cizik MPH, Jason S. Weisstein MD & Ernest U. Conrad III MD

  3. Department of Orthopaedics, Loyola University Medical Center, Chicago, IL, USA

    Timothy B. Rapp MD

Authors
  1. Melissa N. Zimel MD
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  2. Amy M. Cizik MPH
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  3. Timothy B. Rapp MD
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  4. Jason S. Weisstein MD
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  5. Ernest U. Conrad III MD
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Corresponding author

Correspondence to Amy M. Cizik MPH.

Additional information

One of the authors (EUC) has received funding from Stryker Orthopaedics (Mahwah, NJ).

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the University of Washington Medical Center, Seattle, WA.

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Zimel, M.N., Cizik, A.M., Rapp, T.B. et al. Megaprosthesis versus Condyle-sparing Intercalary Allograft: Distal Femoral Sarcoma. Clin Orthop Relat Res 467, 2813–2824 (2009). https://doi.org/10.1007/s11999-009-1024-2

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  • DOI: https://doi.org/10.1007/s11999-009-1024-2

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