medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2013, Number 5

<< Back Next >>

Acta Ortop Mex 2013; 27 (5)

Efficacy of the RIMAG unconventional hip prosthesis in patients with primary bone tumors, metastasis and non-tumor osteoarticular losses

Rico-Martínez G, Delgado-Cedillo EA, Linares-González LM, Lindoro-Félix H, León-Hernández SR

Language: Spanish
References: 14
Page: 299-304
PDF size: 211.48 Kb.


ABSTRACT

Objective: To assess the functional efficacy of the RIMAG unconventional hip prosthesis in cancer and non-cancer patients. Material and methods: Functional analysis of 38 patients with RIMAG arthroplasty, using the Musculoskeletal Tumor Society Scoring System and including the following: functionality versus histologic diagnosis (5 malignancies, 3 metastases, 14 giant cell tumors (GCT), 8 with other benign tumors, and 8 had no tumor), age (40.4 ± 19.1 years), sex (24 females, 14 males), postoperative follow-up (34.7 ± 31.3 months). Analysis of intraoperative, immediate and late complications, time to weight bearing, gait and work or social reintegration were also assessed. Results. Global mean of ideal functionality was 65.6 ± 23.2%. Age was negatively correlated with the functionality rate (r = -0.507, p = 0.001); significant difference with the histologic diagnosis: malignant tumors 54.8, metastasis 58.6, giant cell tumor 25.6, other benign tumors 34.2, non-tumor causes 56.6 (p = 0.001). When functionality means were adjusted for age with a covariance analysis, better percentages were found for benign tumors (79.2 ± 6.8%) and giant cell tumors (76.4 ± 6.3%), less functionality for non-tumor causes (45.7 ± 7.6%), and intermediate percentages for malignant tumors and metastasis (p = 0.03). Intraoperative complications occurred in 4 cases (28.6%), immediate in 3 (7.8%), late in 15 (39.4%); 62.5% of patients started immediate weight bearing, 92.1% resumed their usual activities after surgery. Conclusions: The reconstruction of the proximal femur with RIMAG is a safe and reliable treatment option, with complication rates below the ones reported in the literature. Satisfactory results were obtained, with high functional rates for benign tumors, and low rates in older patients, malignant tumors and metastasis.


REFERENCES

  1. Di Caprio M, Friedlaender G: malignant bone tumors: limb sapring versus amputation. J Am Acad Orthop Surg. 2003; 11: 25-37.

  2. Escandon S, Soto C, Mesa J, Montoya D, Monsalvo D: Megaprótesis de fémur: cirugía de salvamento de extremidad en un paciente con osteosarcoma multicéntrico. Rev Col de Or Tra. 2007; 21: 74-7.

  3. Malawer MM, Sugarbaker PH: Musculoeskeletal Cancer Surgery. Mosby; 1995.

  4. Hattori H, Mibe J, Matsuoka H, Nagai S, Yamamoto K: Surgical management of metastatic disease of the proximal femur. Journal of Orthopeadic Surgery. 2007; 15(3): 195-8.

  5. Bernthal N, Schwartz A, Oakes D, Kabo J, Eckardt J: How long do endoprosthetic reconstruction for proximal femoral tumors last? Clin Orthp Relat Res. 2010; 468: 2867-74.

  6. Damron T, Sim F: Operative treatment for metastatic disease of the pelvis and the proximal end of the femur. J Bone Joint Surg Am. 2000; 82 A(1): 113-26.

  7. Yalniz E, Ciftdemir M, Memisoglu S: Functional results of patients treated with modular prosthetic replacement for bone tumor of the extremities. Acta Orthop Traumatol Turc. 2008; 42(4): 236-45.

  8. Ladero F, Aguilar L, Rodríguez M: Revision hip arthroplasty with PSO tumor prosthesis. Patología del Aparato Locomotor. 2005; 3(3): 168-72.

  9. Natarajan M, Bose J, Rajkumar G: Proximal femur reconstruction with custom mega prosthesis. International Orthopeadics (SICOT). 2003; 27: 175-9.

  10. Rico G, Domínguez V, Muller J, Delgado E, Miranda J, Montoya R: Diseño de una prótesis no convencional bloqueada para cadera (RIMAG) a partir de mediciones de fémures mexicanos. Acta Ortopédica Mexicana. 2008; 22(2): 70-9.

  11. Linares L, Rico G: Incidencia de lesiones tumores y seudotumorales, óseas y de partes de blandas de la cadera y sus alrededores. Rev Mex Ortop Traum. 1996; 12(5): 429-31.

  12. Bertani A, Helix M, Louis M, Rochwerger A, Curvale G: Total Hip Arthroplasty in severe segmental femoral bone loss situation: use of a reconstruction modular stem design (JVC IX). Orthopeadics & Traumatology: Surgery & Research. 2009; 95: 491-7.

  13. Wedin R, Bauer H: Surgical treatment of skeletal metastatic lesions of the proximal femur, Endoprosthesis or Reconstruction nail? J Bone Joint Surg (Br). 2005; 87-B: 1653-7.

  14. Expósito J, Olmo J, Pons Y, Sánchez A: Valoración funcional y calidad de vida en pacientes intervenidos de un tumor óseo primario. Rehabilitación (Madr). 2004; 38(3): 108-14.




2020     |     www.medigraphic.com