INTRODUCTIONWith considerable advances in imaging, implant design, surgical technique and chemotherapeutics, limb salvage surgery has supplanted amputation as the preferred intervention for the majority of patients with a musculoskeletal malignancy. As the ability to treat these malignancies becomes progressively more sophisticated, the utilization of endoprostheses continues to expand, and the survival of patients undergoing endoprosthetic reconstruction continues to improve. With 25‐year implant survival rates reported to be approximately 50%, an increasing number of patients will require revision of their endoprosthesis.The treatment of patients with endoprosthetic failure presents a challenge due to resultant insufficient bone stock, poor muscle function, and lack of normal soft tissue coverage. A prior study by Kabo et al documented a 7‐year survival of 66% for revision endoprostheses, reflecting the difficulty of creating a durable construct in a revision setting. In particular, the revision of cemented endoprostheses is technically demanding. The removal of the implant from stress shielded bone is often fraught with challenges and the ease of simply “cutting above” the cement mantle is tempting for surgeons. This, however, uses additional bone stock and dramatically limits the number of revisions a patient can undergo in their lifetime. It also raises the level of amputation if
Journal of Surgical Oncology – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ;
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