Advances in modular endoprosthetic reconstruction of osseous defects
Current Opinion in Orthopaedics
Bone tumor; Endoprosthesis; Modular; Prosthesis; Reconstruction; Sarcoma
Purpose of review: Reconstruction of segmental skeletal defects after resection of tumors remains a technically challenging procedure. Recent advances and improvements in modular endoprosthetic systems have led to an increased acceptance of this form of reconstruction. Results of recent publications and presentations are summarized. Recent findings: The advent of modular, off-the-shelf components that are assembled during the surgical procedure has virtually replaced the use of custom implants in a majority of patients. Recent reports from large institutions demonstrate the durability of these modular systems, which significantly outperform the older generation of custom implants. Further developments have expanded the indications for modular reconstruction to include anatomically challenging sites such as the shoulder and pelvic girdle, and the skeletally immature patient. Summary: In addition to reconstruction of segmental defects after tumor resection, modular endoprostheses are increasingly used for complicated revisions of the hip and knee after failed total joint replacement. Complications, although less frequent than with custom implants, can often be successfully managed with additional surgery. Further work in reducing the risk of periprosthetic infection and aseptic loosening will advance this growing field.
Henshaw, R., & Malawer, M. (2003). Advances in modular endoprosthetic reconstruction of osseous defects. Current Opinion in Orthopaedics, 14 (6). http://dx.doi.org/10.1097/00001433-200312000-00012