scholarly journals Implant Survival, Clinical Outcome and Complications of Megaprosthetic Reconstructions Following Sarcoma Resection

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 351
Author(s):  
Christoph Theil ◽  
Jan Schwarze ◽  
Georg Gosheger ◽  
Burkhard Moellenbeck ◽  
Kristian Nikolaus Schneider ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Outcome ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Bone Defects ◽  
Implant Survival ◽  
Implant Survivorship ◽  
Orthopedic Oncology ◽  
Segmental Bone

Megaprosthetic reconstruction of segmental bone defects following sarcoma resection is a frequently chosen surgical approach in orthopedic oncology. While the use of megaprostheses has gained popularity over the last decades and such implants are increasingly used for metastatic reconstructions and in non-tumor cases, there still is a high risk of long-term complications leading to revision surgery. This article investigates current implant survivorship, frequency and types of complications as well as functional outcomes of upper and lower limb megaprosthetic reconstructions.

Long term results of lower limb posttraumatic acute bone defects treated with masquelet technique

Injury ◽  
2021 ◽  
Author(s):  
Gonzalo Luengo-Alonso ◽  
Ismael Auñon Martin ◽  
Victor Rodriguez Vega ◽  
Aranzazu Capel Agundez ◽  
Pedro Caba Doussoux
Keyword(s):  
Lower Limb ◽  
Bone Defects ◽  
Long Term Results ◽  
Masquelet Technique

Bone transport osteogenesis for treatment of canine osteomyelitis

2010 ◽  
Vol 23 (02) ◽  
pp. 134-140 ◽  
Author(s):  
S. W. Petersen ◽  
L. M. Déjardin ◽  
D. Ting
Keyword(s):  
Bone Defects ◽  
Bone Transport ◽  
Infected Nonunion ◽  
Non Union ◽  
Post Surgery ◽  
Bone Segment ◽  
Extensive Debridement ◽  
Segmental Bone ◽  
Osseous Defects

SummaryBone transport osteogenesis, as described by Ilizarov, has been used to resolve segmental bone defects in both human and veterinary patients. These defects are created when a large osseous tumour, sequestrum, or non-union fracture is resected. This report documents two cases in which the principle of bone transport osteogenesis was applied by utilising the Ilizarov technique to bridge large osseous defects resulting from debridement of an infected nonunion fracture (case 1) and debridement of a sequestrum (case 2). Defects were treated by transporting either a complete or a hemi-circumferential bone segment. Both cases had resolution of osteomyelitis, satisfactory fracture union, and functional usage of the limb 39 weeks and 15 weeks post-surgery, respectively. Although manageable complications were encountered during the treatment of these cases, the long-term clinical outcome was eventually favorable. The authors believe that bone transport osteogenesis offers a valid restorative option in the treatment of bone defects resulting from extensive debridement and sequestrectomy.

Clonal Involvement of the CD34+CD33− Progenitor Population by Leukemic Cells Harboring FLT3/ITD Correlates with High Risk of Relapse in Pediatric Acute Myeloid Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 227-227
Author(s):  
Jessica A. Wright ◽  
Todd A. Alonzo ◽  
Robert B. Gerbing ◽  
William G. Woods ◽  
Beverly J. Lange ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
High Risk ◽  
Clinical Outcome ◽  
Myeloid Leukemia ◽  
Poor Clinical Outcome ◽  
Free Survival ◽  
Allelic Ratio ◽  
Risk Of Relapse ◽  
Acute Myeloid

Abstract Internal tandem duplication of the FLT3 gene (FLT3/ITD) has been associated with high risk of relapse in acute myeloid leukemia (AML) yet nearly 25–30% of the patients with FLT3/ITD have long-term disease free survival with conventional chemotherapy. We hypothesized that FLT3/ITD AML patients with poor clinical outcome may have disease that involves less mature hematopoietic precursors than patients with favorable outcome. To test this hypothesis, we isolated less mature, CD34+CD33− and more mature, CD34+CD33+ precursor cells from 24 pediatric AML patients enrolled on Children’s Cancer Group clinical trials CCG-2891 and 2961 previously identified as having a FLT3/ITD. Granulocyte/monocyte colonies (CFU-GM) were grown in methylcellulose, harvested, and analyzed for the presence of FLT3/ITD after 14 days of growth. Twenty patients yielded sufficient cells and growth of CFU-GM colonies for analysis. FLT3/ITD was detected in CFU-GM colonies derived from CD34+CD33+ cells in all patient samples (median 80% of colonies tested per patient, range 6–100%). In contrast, FLT3/ITD was detected in CFU-GM colonies derived from CD34+/CD33− cells in only 11 of the 20 patient samples (median 46% of colonies tested per patient, range 6–100%). Of the 9 patient samples without FLT3/ITD involvement of CD34+CD33− colonies, 8 achieved a CR, 6 of whom are long-term survivors, and one patient died of non-leukemic causes. In contrast, of the 11 patients with CD34+CD33− cell involvement, 9 either failed to achieve CR or relapsed after achieving CR, and 2 died of non-leukemic causes. Actuarial progression-free survival at 4 years from diagnosis for the patients with and without FLT3/ITD in the CD34+CD33− population was 0% vs. 68% respectively (p=0.017). As allelic ratio of the FLT3/ITD has been used to define high-risk patients within the FLT3/ITD cohort, we determined the FLT3/ITD allelic ratio in our study population and correlated it with the presence of FLT3/ITD in the CD34+CD33− population. Ten of the 11 (91%) of the patient samples with FLT3/ITD involvement of the progenitor cells had high allelic ratio compared to 5 of 9 (56%) of the patients without early cell involvement. Together these data suggest that clonal dominance of FLT3/ITD containing leukemia cells at the CD34+CD33− stage of hematopoietic development is correlated with a high risk of relapse. Further studies are required to determine whether clonal dominance at this hematopoietic stage is a variable that, independent of high allelic ratio, accounts for the poor clinical outcome seen in a subset of FLT3/ITD positive AML patients.

Soft Tissue Coverage in Distal Lower Extremity Open Fractures: Comparison of Free Anterolateral Thigh and Free Latissimus Dorsi Flaps

2017 ◽  
Vol 34 (02) ◽  
pp. 121-129 ◽  
Author(s):  
Pierre Moullot ◽  
André M. Gay ◽  
Baptiste Bertrand ◽  
Régis Legré ◽  
Nathalie Kerfant ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Free Flaps ◽  
Open Fractures ◽  
Soft Tissue Coverage ◽  
Aesthetic Outcome ◽  
Anterolateral Thigh ◽  
Alt Flap

Background When microsurgical transfers are required in posttraumatic lower limb reconstruction, surgeons must choose among many types of free flaps. Historically, surgeons have advocated muscular flaps for coverage of open lower extremity wounds, but fasciocutaneous free flaps are now often used with good results. This study aimed to compare the functional and aesthetic outcome of reconstruction by free muscular latissimus dorsi (LD) flap and free fasciocutaneous anterolateral thigh (ALT) flap used for soft tissue coverage of distal lower extremity open fractures. Methods We performed a single-center, retrospective study of subjects with distal lower limb open fractures treated with LD flaps or ALT flaps between 2008 and 2014. Patients with limited follow-up or incomplete data were excluded from the analysis. Donor and recipient sites, early complications and long-term outcomes (functional and aesthetic) were studied and compared according to the type of flap. Results A total of 47 patients were included: 27 patients in the LD flap group and 20 patients in the ALT flap group. No significant difference was found regarding early and late complications and long-term functional outcomes (bone healing, infectious bone complications, flap healing). As for aesthetic outcome and donor-site morbidity, reconstruction using the ALT free flap had significantly better results (p < 0.05). Conclusions In posttraumatic lower limb injury, either LD or ALT free flaps can be used for wound coverage with comparable long-term functional outcomes. The ALT flap provides better cosmetic results than LD.

scholarly journals Efficacy Comparison of Trifocal Bone Transport Using Unilateral External Fixator for Femoral and Tibial Bone Defects Caused by Infection

2021 ◽  
Author(s):  
Kai Liu ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Chenchen Fan ◽  
Peng Ren ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Bone Defects ◽  
Bone Transport ◽  
Limb Bone ◽  
The Mean ◽  
Fair Poor

Abstract Background: This study aimed to evaluate the clinical and functional outcomes of patients with critical femoral and tibial bone defects treated by trifocal bone transport using the Ilizarov method.Methods: In a retrospective comparative study, 39 patients treated for lower limb bone non-union with bone loss measuring between 6 and 14 cm were included. Depending on the location of bone transport, the patients were divided into the femur group (n =18) and tibia groups (n =21). The demographics data, intraoperative records, and postoperative outcomes were documented and compared between the two groups. At the last follow-up, the bone and functional outcomes were evaluated according to the criterion given by the Association for the Study and Application of the Method of the Ilizarov (ASAMI) and postoperative complications evaluated by Paley classification.Results: The average follow-up time was 26.1 months (range 17–34 months) since the unilateral external fixators were removed. The mean size of the bone defect was 8.3 cm in the femur group, and 7.5 cm in the tibia group. All bone defects were reconstructed successfully. The mean time in external fixation in the femur group was 334.4 days, and in the tibia group was 344.6 days. The external fixation index (EFI) measured 55.9 days/cm in the femur group and 65 days/cm in the tibia group. A statistically significant difference of bone grade was found between the two groups (excellent/good/fair/poor, 3/11/3/1 vs 2/13/4/2, P<0.05), as well as the function grade in two groups (excellent/good/fair/poor/failure, 3/14/1/0 vs 4/13/3/1, P<0.05). According to the ASAMI classification, the clinical and functional results in the femur group were better than in the tibia group. The complication rate of the two groups was 94.4% vs 76.2% (femur vs tibia). One femur and five tibias were performed additional surgery because of delayed union and axial deviation. Conclusions: The trifocal bone transport using the unilateral external fixator is a reliable treatment in the management of post-traumatic and post-infection lower limb bone defects (>6cm). In the comparison of the tibia, the trifocal bone transport treatment period of the femur was shorter, the functional recovery was better and the risk of minor complications was higher.

Patient Weight more than Body Mass Index Influences Total Hip Arthroplasty Long Term Survival

2011 ◽  
Vol 21 (6) ◽  
pp. 694-699 ◽  
Author(s):  
Francesco Traina ◽  
Barbara Bordini ◽  
Marcello De Fine ◽  
Aldo Toni
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Implant Survival ◽  
Term Survival ◽  
Long Term Survival ◽  
Implant Survivorship

The effect of obesity on the long-term survival of total hip arthroplasty remains under discussion. Reviewing meta-analyses of large cohort studies a high body mass index has been correlated with a higher incidence of complications but not univocally with a lower implant survival rate. It has been suggested that body weight rather than body mass index might be a better parameter to evaluate prosthesis outcome. We reviewed 27,571 patients retrospectively with primary arthritis as a preoperative diagnosis. Patients were divided into 4 categories based on their body mass index, or into two groups based on the body weight (<80 kg and 80 kg). Implant survivorship was estimated with use of the Cox proportional hazards model with revision for aseptic loosening as the end point. Results were stratified for sex and implant tribology. When body mass index was used the 10 years implant survival in obese versus non-obese patients was not statistically different (p=0.058), but when body weight was used a statistically different implant survivorship was found for men (p=0.009). Therefore, weight rather than than body mass index influences survival of hip prostheses, and should be used as the discriminant parameter for further studies.

Sign in / Sign up

Export Citation Format

Share Document