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Megaprosthesis for Metastatic Bone Disease—A Comparative Analysis
Article

Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis

1
First Department of Orthopedic Surgery, St. Anne’s University Hospital, 65691 Brno, Czech Republic
2
Faculty of Medicine, Masaryk University, 60177 Brno, Czech Republic
3
Clinic of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, 60200 Brno, Czech Republic
4
First Pathology Department, St. Anne’s University Hospital, 65691 Brno, Czech Republic
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Curr. Oncol. 2022, 29(5), 3519-3530; https://doi.org/10.3390/curroncol29050284
Received: 27 March 2022 / Revised: 4 May 2022 / Accepted: 9 May 2022 / Published: 13 May 2022
(This article belongs to the Special Issue Treatment of Bone Metastasis)
Background: The purpose of this study was to evaluate the implant survival, functional score and complications of intercalary endoprostheses implanted for metastatic involvement of the femoral and humeral diaphysis. Methods: The selected group covered patients with bone metastasis who were surgically treated with an intercalary endoprosthesis between 2012 and 2021. The functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system, and complications were evaluated by using the failure classification for prosthetics designed by Henderson. Results: The mean follow-up was 29.8 months. In our group of 25 patients with 27 intercalary endoprostheses (18 femurs, 9 humeri), there were 7 implant-related complications (25.9%), which were more common on the humerus (4 cases, 44.4%) than on the femur (3 cases, 16.7%). Only type II failure—aseptic loosening (5 cases, 18.5%)—and type III failure—structural failure (2 cases, 7.4%)—occurred. There was a significantly higher risk of aseptic loosening of the endoprosthesis in the humerus compared with that in the femur (odds ratio 13.79, 95% confidence interval 1.22–151.05, p = 0.0297). The overall cumulative implant survival was 92% 1 year after surgery and 72% 5 years after surgery. The average MSTS score was 82%. The MSTS score was significantly lower (p = 0.008) in the humerus (75.9%) than in the femur (84.8%). Conclusions: The resection of bone metastases and replacement with intercalary endoprosthesis has excellent immediate functional results with an acceptable level of complications in prognostically favourable patients. View Full-Text
Keywords: bone neoplasm; metastasis; diaphysis of long bones; intercalary endoprosthesis bone neoplasm; metastasis; diaphysis of long bones; intercalary endoprosthesis
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MDPI and ACS Style

Mahdal, M.; Pazourek, L.; Apostolopoulos, V.; Adámková Krákorová, D.; Staniczková Zambo, I.; Tomáš, T. Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis. Curr. Oncol. 2022, 29, 3519-3530. https://doi.org/10.3390/curroncol29050284

AMA Style

Mahdal M, Pazourek L, Apostolopoulos V, Adámková Krákorová D, Staniczková Zambo I, Tomáš T. Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis. Current Oncology. 2022; 29(5):3519-3530. https://doi.org/10.3390/curroncol29050284

Chicago/Turabian Style

Mahdal, Michal, Lukáš Pazourek, Vasileios Apostolopoulos, Dagmar Adámková Krákorová, Iva Staniczková Zambo, and Tomáš Tomáš. 2022. "Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis" Current Oncology 29, no. 5: 3519-3530. https://doi.org/10.3390/curroncol29050284

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