Coaxial extendible knee equalizes limb length in children with osteogenic sarcoma Journal Article


Authors: Arkader, A.; Viola, D. C. M.; Morris, C. D.; Boland, P. J.; Healey, J. H.
Article Title: Coaxial extendible knee equalizes limb length in children with osteogenic sarcoma
Abstract: We assessed our ability to achieve limb length equality (LLE) in children following limb-sparing surgery for distal femur osteogenic sarcoma using coaxial extendible prostheses in 12 children, averaging 11.6 years old at the time of tumor resection (range, 5.9-15.5 years). All but one child achieved clinical limb length equality. There were 23 extensions, averaging 3.8 extensions per patient (range, 1-5), by an average 13 mm per extension and an average total extension of 49.3 mm per patient extended. Eight children underwent revision surgery after an average of 45.1 months (range, 3-115 months). Aseptic loosening occurred more frequently among children with greater femoral diameter growth. The overall prosthetic survival was 60% at 3 years and 35% at 5 years. The survival until aseptic loosening at 3 and 5 years was 85% and 45%, respectively. Press-fit components survived longer than cemented stems. None of the devices loosened. At skeletal maturity the MSTS functional scores averaged 25. Using a coaxial extendible implant, we efficiently achieved LLE in this population. Prosthetic revision was needed frequently. Younger age and longer resection percentages were associated with shorter prosthetic survival and higher revision/aseptic loosening rates. Femoral diameter growth may contribute to loosening. Early experience with this extendible implant is promising. Ā© 2007 Lippincott Williams & Wilkins, Inc.
Keywords: osteosarcoma; survival; adolescent; child; clinical article; preschool child; child, preschool; cancer surgery; implant; limb salvage; retrospective studies; conference paper; cohort studies; cohort analysis; retrospective study; instrumentation; limb; femur; prosthesis; femur tumor; prosthesis design; prosthesis failure; femoral neoplasms; bone screw; leg length; leg length inequality; internal fixators
Journal Title: Clinical Orthopaedics and Related Research
Volume: 459
ISSN: 0009-921X
Publisher: Springer  
Date Published: 2007-06-01
Start Page: 60
End Page: 65
Language: English
DOI: 10.1097/BLO.0b013e3180514c37
PUBMED: 17438477
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 6" - "Export Date: 17 November 2011" - "CODEN: CORTB" - "Source: Scopus"
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MSK Authors
  1. Patrick J Boland
    149 Boland
  2. Carol Morris
    55 Morris
  3. John H Healey
    478 Healey