Comparison between constrained and semiconstrained knee allograft-prosthesis composite reconstructions Journal Article


Authors: Farfalli, G. L.; Aponte-Tinao, L. A.; Ayerza, M. A.; Muscolo, D. L.; Boland, P. J.; Morris, C. D.; Athanasian, E. A.; Healey, J. H.
Article Title: Comparison between constrained and semiconstrained knee allograft-prosthesis composite reconstructions
Abstract: Allograft-prosthesis composite (APC) can restore capsular and ligamentous tissues of the knee sacrificed in a tumor extirpation. We asked if performing APC would restore knee stability and allow the use of nonconstrained arthroplasty while preventing aseptic loosening. We retrospectively compared 50 knee APCs performed with non-constrained revision knee prosthesis (Group 1) with 36 matched APCs performed with a constrained prosthesis (Group 2). In Group 1, the survival rate was 69% at five and 62% at ten years. Sixteen reconstructions were removed due to complications: eight deep infections, three fractures, two instabilities, one aseptic loosening, one local recurrence, and one nonunion. In Group 2, the survival rate was 80% at five and 53% at ten years. Nine reconstructions were removed: 3 due to deep infections, 3 to fractures, and 3 to aseptic loosening. In both groups, we observed more allograft fractures when the prosthetic stem does not bypass the host-donor osteotomy (P > 0.05). Both groups had mainly good or excellentMSTS functional results. Survival rate and functional scores and aseptic loosening were similar in both groups. A rotating-hinge APC is recommended when host-donor soft tissue reconstruction fails to restore knee instability.The use of a short prosthetic stem has a statistical relationship with APC fractures. Copyright © 2013 German L. Farfalli et al.
Keywords: osteosarcoma; adolescent; adult; child; controlled study; school child; aged; cancer surgery; survival rate; major clinical study; overall survival; comparative study; retrospective study; survival time; fibrosarcoma; lymphoma; surgical infection; scoring system; leiomyosarcoma; prosthesis loosening; chondrosarcoma; osteotomy; giant cell tumor; knee arthroplasty; knee prosthesis; allograft prosthesis composite; composite material; constrained prosthesis; dermoplastic fibroma; knee allograft; knee fracture; knee instability; malignant fibrohistiocytoma; nonconstrained prosthesis; traumatic bone loss
Journal Title: Sarcoma
Volume: 2013
ISSN: 1357-714X
Publisher: Hindawi Publishing Corporation  
Date Published: 2013-01-01
Start Page: 489652
Language: English
DOI: 10.1155/2013/489652
PROVIDER: scopus
PMCID: PMC3586499
PUBMED: 23476114
DOI/URL:
Notes: --- - "Export Date: 21 May 2013" - "CODEN: SARCF" - "Source: Scopus"
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MSK Authors
  1. Patrick J Boland
    135 Boland
  2. Carol Morris
    53 Morris
  3. John H Healey
    387 Healey