FUNCTIONAL OUTCOME FOLLOWING PROXIMAL TIBIAL TUMOR RESECTION AND RECONSTRUCTION BY MODULAR PROSTHESIS

Abdellatif, Mohammed Hassan; Mohamed, Abdallah Attia; Ebeid, Walid Atef; Mohammad, Mohammad Othman

doi:10.21608/zumj.2021.52258.2045

FUNCTIONAL OUTCOME FOLLOWING PROXIMAL TIBIAL TUMOR RESECTION AND RECONSTRUCTION BY MODULAR PROSTHESIS

Document Type : Original Article

Authors

¹ Zagazig University,faculty of medicine, orthopedic department

² Professor of Orthopedic Surgery, Faculty of Medicine - Zagazig University

³ Orthopedic surgery department, Cairo University

⁴ Orthopedic surgery department, faculty of medicine, Zagazig University, Zagazig, Egypt

10.21608/zumj.2021.52258.2045

Abstract

Abstract
Background and Objectives
The proximal tibia is a common site for bone tumors. Proximal tibial endoprosthetic reconstruction is one of the popular treatment options. However, proximal tibial reconstruction have been associated with many complications. The aim of our study was to evaluate the functional outcome and complications of patients with proximal tibial endoprosthesis.
Methods
A retrospective study of prospective database was done during the period between January (2000) and July (2017). Eighty one patients with proximal tibial tumor underwent resection and endoprosthetic reconstruction of the proximal tibia. The functional outcome was evaluated using MSTS scoring system and the range of knee motion. Postoperative complications were classified according to Henderson classification; Type 1(soft tissue failure), Type 2 (aseptic loosening), Type 3 (structural failure), Type 4 (infection) and Type 5 (local tumor progression).
Results
The mean follow up period was 73.08 ± 51.17 months (range 24 – 204 months). The mean MSTS score was 26.14 ± 2.62 (range 16-30), the mean ROM was 71.54 ± 25.55 (range 10 –120), the mean extension lag was 14.44 ± 14.66 (range 0-60). Overall complications occurred in 69.1% of our patients, Type 1 (soft tissue failure) occurred in 8.6%, Type 2 (Aseptic loosening) occurred 13.6%, Type 3 (structural failure) occurred in 19.8%, Type 4 (infection) occurred in 32.1%, Type 5 (tumor recurrence) occurred in 6.2%.
Conclusion
Endoprosthetic replacement of the proximal tibia offers a reliable technique for preserving the limb with an acceptable limb function. Although complications are considerable, they are mostly manageable.

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