Reconstruction of Periacetabular Tumours with Saddle Prosthesis or Custom-Made Prosthesis, Functional Results and Complications

AimsReconstruction of the acetabulum after resection of a periacetabular malignancy is technically challenging and many different techniques have been used with varying success. Our aim was to prepare a systematic review of the literature dealing with these techniques in order to clarify the management, the rate of complications and the outcomes.Patients and MethodsA search of PubMed and MEDLINE was conducted for English language articles published between January 1990 and February 2017 with combinations of key search terms to identify studies dealing with periacetabular resection with reconstruction in patients with a malignancy. Studies in English that reported radiographic or clinical outcomes were included. Data collected from each study included: the number and type of reconstructions, the pathological diagnosis of the lesions, the mean age and follow-up, gender distribution, implant survivorship, complications, functional outcome, and mortality. The results from individual studies were combined for the general analysis, and then grouped according to the type of reconstruction.ResultsA total of 57 studies met the inclusion criteria and included 1700 patients. Most lesions were metastatic (41%), followed by chondrosarcoma (29%), osteosarcoma (10%), Ewing’s sarcoma (7%), and multiple myeloma (2%). The techniques of reconstruction were divided into seven types for analysis: those involving a Harrington reconstruction, a saddle prosthesis, an allograft and allograft prosthesis composite, a pasteurised autograft, a porous tantalum implant, a custom-made prosthesis and a modular hemipelvic reconstruction. The rate of complications was 50%, with infection (14%) and instability (8%) being the most common. Mortality data were available for 1427 patients (84%); 50% had died of disease progression, 23% were alive with disease, and 27% had no evidence of disease at a mean follow-up of 3.4 years (0 to 34).ConclusionBoth the rate of complications and mortality are high following resection of oncological periacetabular lesions and reconstruction. Many types of reconstruction have been used with unique challenges and complications for each technique. Newer prostheses, including custom-made prostheses and porous tantalum implants and augments, have shown promising early functional and radiographic outcomes. Cite this article: Bone Joint J 2018;100-B(1 Supple A):22–30.

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An engineering-based approach for design and fabrication of a customized nasal prosthesis

Prosthetics and Orthotics International ◽

10.1177/0309364614535232 ◽

2014 ◽

Vol 39 (5) ◽

pp. 422-428 ◽

Cited By ~ 8

Author(s):

Rui Neto ◽

António Costa-Ferreira ◽

Nuno Leal ◽

Margarida Machado ◽

Ana Reis

Keyword(s):

Three Dimensional ◽

Cost Effective ◽

Functional Results ◽

Invasive Treatment ◽

Non Invasive ◽

Facial Defects ◽

Custom Made ◽

Dimensional Reconstruction ◽

Silicone Prostheses

Background and aim: Facial defects (from neoplasms, trauma, etc.) can be functionally and emotionally devastating. A non-invasive treatment for these defects is the application of external prostheses. Conventionally, these prostheses are fabricated by an anaplastologist through a manual procedure, which is an expensive and time-consuming approach. Current advances in computational and engineering tools report an improvement in design and manufacturing of silicone prostheses. This demand motivated this study that aims to develop a methodology for fabricating customized nasal prostheses. Technique: In this study, an 80-year-old woman with a total defect of the nose is considered as case-study. The proposed methodology entails six tasks: (a) data acquisition, (b) three-dimensional reconstruction, (c) prosthesis design, (d) moulds fabrication, (e) prosthesis manufacturing and (f) final fittings. Discussion: The presented approach showed encouraging outcomes since it saves time, reduces costs and allows the achievement of prosthesis with the minimum contact and discomfort to the patient, disclosing excellent aesthetic and functional results. Clinical relevance Custom-made nasal prostheses with minimum contact and discomfort for the patient can be achieved using an engineering approach based on digital technologies and additive manufacturing that is cost-effective and less time-consuming than the manual procedure.

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Unconventional Solution for a Complex Elbow Problem, 12 Year Followup: A Case Report

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i04/864 ◽

2020 ◽

Vol 5 (04) ◽

Author(s):

Dr. Bharghava Ram U ◽

Dr. Venkata Ramana U ◽

Dr. Ch. S. Nishanth

Keyword(s):

Case Report ◽

Male Student ◽

Functional Results ◽

Distal Humerus ◽

Good Alternative ◽

Complete Healing ◽

Total Elbow Arthroplasty ◽

Elbow Arthroplasty ◽

Complex Fractures ◽

Custom Made

Introduction: In the past, the indications for elbow arthroplasty were quite limited and included cases of rheumatoid arthritis and post-traumatic arthrosis. Nowadays, the use of elbow arthroplasty may be necessary in selected cases of complex fractures of the elbow, with good functional results. Several methods have been developed to deal with massive bone defects during revision surgery. Complex surgical steps also bring more injury, thus increasing soft tissue‐related complications. The aim of this case report is to evaluate the role of elbow arthroplasty as a primary option and the challenges in subsequent revision surgeries. Case Report: We describe the case of a 14 year old male student, who presented to our emergency department with a side swipe injury to the right elbow on 28 may 2008. He presented with a large open wound with triceps muscle loss and missing entire distal humerus along with a part of olecranon, neurovascular structures intact. After 1 month complete healing of the flap a custom made uncemented total elbow arthroplasty was done through anterior approach. In 12 years he underwent 2 revisions with ROM of 0-80 degrees and 4cm shortening of upper limb. Restricted pronation and supination compensated by shoulder. He completed his graduation and now working as a software engineer. Conclusion: Total elbow arthroplasty is a good alternative for elbow complex fractures. Revision scenarios pose various challenges and sometimes need outside the box thinking. Inserting an ulnar prosthesis into the radius is a novel procedure for patients non reconstructable ulna. It is a safe, quick, and effective treatment with a promising outcome.

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Esthetic, functional, and prosthetic outcomes with implant-retained finger prostheses

Prosthetics and Orthotics International ◽

10.1177/0309364612449850 ◽

2012 ◽

Vol 37 (2) ◽

pp. 168-174 ◽

Cited By ~ 6

Author(s):

Cemal Aydin ◽

Secil Karakoca Nemli ◽

Handan Yilmaz

Keyword(s):

Composite Resin ◽

Index Finger ◽

Hand Function ◽

Functional Results ◽

Psychological Status ◽

Traumatic Amputation ◽

Psychological Benefits ◽

Osseointegrated Implants ◽

Custom Made ◽

Silicone Prostheses

Background: Traumatic amputation of fingers results in a serious impairment of hand function and affects the psychological status of the patients. The implant-retained finger prostheses are an alternative treatment. The aim of this case report is to represent the use of osseointegrated implants for retention of finger prostheses in a patient with amputated thumb and index finger. Case Description and Methods: Dental implants were placed in the residual bone of the fingers using two-stage surgery. Custom-made attachments were used to provide retention between implants and silicone prostheses. Prosthetic fingernails were made of composite resin material. Findings and Outcomes: After 6 months, implants were clinically successful, and the patient was satisfied with the appearance and the function of the prostheses. The complications of broken prosthetic nail and mild discoloration were observed. Conclusion: Reconstruction of amputated fingers with implant-retained prosthesis is a worthwhile treatment providing esthetic, functional, and psychological benefits, although some complications might be experienced. Clinical relevance Implant-retained finger prostheses are an acceptable treatment modality for patients with amputated fingers. Evaluating implant prognosis, functional results and prosthetic results of the patients are necessary to address the benefits and complications of the treatment.

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