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Expandable distal femur megaprosthesis : a European Musculoskeletal Oncology Society study on 299 cases

(2020) JOURNAL OF SURGICAL ONCOLOGY. 122(4). p.760-765
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Abstract
Background and Objectives Expandable distal femur prostheses have become more popular over the last decades, but scientific data is limited. Methods A retrospective study was performed, including cases treated between 1986 and 2019 in 15 European referral centers for bone sarcomas. Results A total of 299 cases were included. Average follow-up was 80 months (range, 8-287 months). Mean patient age was 10 years. Most (80%) of the implants were noninvasive growers and a fixed hinge knee was used more often (64%) than a rotating hinge. Most prosthetic designs showed good (>80%) implant survival at 10 years, but repeat surgery was required for 63% of the patients. The most frequent reason for revision procedure was the completion of lengthening potential. Noninvasive expandable implants showed less risk of infection compared to invasive growers (11.8% vs 22.9% at 10 years). No difference in aseptic loosening was found between cemented and uncemented stems. Conclusions This study shows the increasing popularity of expandable distal femur prostheses, with overall good results for function and implant survival. However, repeat surgery is frequently required, especially in patients under the age of 10 years old. Infection is less frequent in noninvasive growers compared to implants that require invasive lengthening procedures.
Keywords
Surgery, Oncology, General Medicine, bone tumor, distal femur, lengthening prosthesis, magnetic, pediatric tumor, LIMB-SALVAGE SURGERY, ENDOPROSTHESIS, CHILDREN, PROSTHESIS

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MLA
Staals, Eric Lodewijk, et al. “Expandable Distal Femur Megaprosthesis : A European Musculoskeletal Oncology Society Study on 299 Cases.” JOURNAL OF SURGICAL ONCOLOGY, vol. 122, no. 4, 2020, pp. 760–65, doi:10.1002/jso.26060.
APA
Staals, E. L., Sambri, A., Campanacci, D. A., Muratori, F., Leithner, A., Gilg, M. M., … Donati, D. M. (2020). Expandable distal femur megaprosthesis : a European Musculoskeletal Oncology Society study on 299 cases. JOURNAL OF SURGICAL ONCOLOGY, 122(4), 760–765. https://doi.org/10.1002/jso.26060
Chicago author-date
Staals, Eric Lodewijk, Andrea Sambri, Domenico Andrea Campanacci, Francesco Muratori, Andreas Leithner, Magdalena Maria Gilg, Yair Gortzak, et al. 2020. “Expandable Distal Femur Megaprosthesis : A European Musculoskeletal Oncology Society Study on 299 Cases.” JOURNAL OF SURGICAL ONCOLOGY 122 (4): 760–65. https://doi.org/10.1002/jso.26060.
Chicago author-date (all authors)
Staals, Eric Lodewijk, Andrea Sambri, Domenico Andrea Campanacci, Francesco Muratori, Andreas Leithner, Magdalena Maria Gilg, Yair Gortzak, Michiel Van De Sande, Edwin Dierselhuis, Eric Mascard, Reinhard Windhager, Philipp Funovics, Martina Schinhan, Oleg Vyrva, Gwen Sys, Nikolay Bolshakov, Will Aston, Panagiotas Gikas, Thomas Schubert, Lee Jeys, Adesegun Abudu, Marco Manfrini, and Davide Maria Donati. 2020. “Expandable Distal Femur Megaprosthesis : A European Musculoskeletal Oncology Society Study on 299 Cases.” JOURNAL OF SURGICAL ONCOLOGY 122 (4): 760–765. doi:10.1002/jso.26060.
Vancouver
1.
Staals EL, Sambri A, Campanacci DA, Muratori F, Leithner A, Gilg MM, et al. Expandable distal femur megaprosthesis : a European Musculoskeletal Oncology Society study on 299 cases. JOURNAL OF SURGICAL ONCOLOGY. 2020;122(4):760–5.
IEEE
[1]
E. L. Staals et al., “Expandable distal femur megaprosthesis : a European Musculoskeletal Oncology Society study on 299 cases,” JOURNAL OF SURGICAL ONCOLOGY, vol. 122, no. 4, pp. 760–765, 2020.
@article{8664953,
  abstract     = {{Background and Objectives Expandable distal femur prostheses have become more popular over the last decades, but scientific data is limited.

Methods A retrospective study was performed, including cases treated between 1986 and 2019 in 15 European referral centers for bone sarcomas.

Results A total of 299 cases were included. Average follow-up was 80 months (range, 8-287 months). Mean patient age was 10 years. Most (80%) of the implants were noninvasive growers and a fixed hinge knee was used more often (64%) than a rotating hinge. Most prosthetic designs showed good (>80%) implant survival at 10 years, but repeat surgery was required for 63% of the patients. The most frequent reason for revision procedure was the completion of lengthening potential. Noninvasive expandable implants showed less risk of infection compared to invasive growers (11.8% vs 22.9% at 10 years). No difference in aseptic loosening was found between cemented and uncemented stems.

Conclusions This study shows the increasing popularity of expandable distal femur prostheses, with overall good results for function and implant survival. However, repeat surgery is frequently required, especially in patients under the age of 10 years old. Infection is less frequent in noninvasive growers compared to implants that require invasive lengthening procedures.}},
  author       = {{Staals, Eric Lodewijk and Sambri, Andrea and Campanacci, Domenico Andrea and Muratori, Francesco and Leithner, Andreas and Gilg, Magdalena Maria and Gortzak, Yair and Van De Sande, Michiel and Dierselhuis, Edwin and Mascard, Eric and Windhager, Reinhard and Funovics, Philipp and Schinhan, Martina and Vyrva, Oleg and Sys, Gwen and Bolshakov, Nikolay and Aston, Will and Gikas, Panagiotas and Schubert, Thomas and Jeys, Lee and Abudu, Adesegun and Manfrini, Marco and Donati, Davide Maria}},
  issn         = {{0022-4790}},
  journal      = {{JOURNAL OF SURGICAL ONCOLOGY}},
  keywords     = {{Surgery,Oncology,General Medicine,bone tumor,distal femur,lengthening prosthesis,magnetic,pediatric tumor,LIMB-SALVAGE SURGERY,ENDOPROSTHESIS,CHILDREN,PROSTHESIS}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{760--765}},
  title        = {{Expandable distal femur megaprosthesis : a European Musculoskeletal Oncology Society study on 299 cases}},
  url          = {{http://dx.doi.org/10.1002/jso.26060}},
  volume       = {{122}},
  year         = {{2020}},
}

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