PMID- 31154850
OWN - NLM
STAT- MEDLINE
DCOM- 20190607
LR  - 20190607
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 101-B
IP  - 6
DP  - 2019 Jun
TI  - Long-term follow-up of custom cross-pin fixation of 56 tumour endoprosthesis 
      stems: a single-institution experience.
PG  - 724-731
LID - 10.1302/0301-620X.101B6.BJJ-2018-0993.R1 [doi]
AB  - AIMS: Aseptic loosening is a major cause of failure in cemented endoprosthetic 
      reconstructions. This paper presents the long-term outcomes of a custom-designed 
      cross-pin fixation construct designed to minimize rotational stress and 
      subsequent aseptic loosening in selected patients. The paper will also examine 
      the long-term survivorship and modes of failure when using this technique. 
      PATIENTS AND METHODS: A review of 658 consecutive, prospectively collected 
      cemented endoprosthetic reconstructions for oncological diagnoses at a single 
      centre between 1980 and 2017 was performed. A total of 51 patients were 
      identified with 56 endoprosthetic implants with cross-pin fixation, 21 of which 
      were implanted following primary resection of tumour. Locations included distal 
      femoral (n = 36), proximal femoral (n = 7), intercalary (n = 6), proximal humeral 
      (n = 3), proximal tibial (n = 3), and distal humeral (n = 1). RESULTS: The median 
      follow-up was 132 months (interquartile range (IQR) 44 to 189). In all, 20 stems 
      required revision: eight for infection, five for structural failure, five for 
      aseptic loosening, and two for tumour progression. Mechanical survivorship at 
      five, ten, and 15 years was 84%, 78%, and 78%, respectively. Mechanical failure 
      rate varied by location, with no mechanical failures of proximal femoral 
      constructs and distal femoral survivorship of 82%, 77%, and 77% at five, ten, and 
      15 years. The survivorship of primary constructs at five years was 74%, with no 
      failure after 40 months, while the survivorship for revision constructs was 89%, 
      80%, and 80% at five, ten, and 15 years. CONCLUSION: The rate of mechanical 
      survivorship in our series is similar to those reported for other methods of 
      reconstruction for short diaphyseal segments, such as compressive 
      osseointegration. The mechanical failure rate differed by location, while there 
      was no substantial difference in long-term survival between primary and revision 
      reconstructions. Overall, custom cross-pin fixation is a viable option for 
      endoprosthetic reconstruction of short metaphyseal segments with an acceptable 
      rate of mechanical failure. Cite this article: Bone Joint J 2019;101-B:724-731.
FAU - Bernthal, N M
AU  - Bernthal NM
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Upfill-Brown, A
AU  - Upfill-Brown A
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Burke, Z D C
AU  - Burke ZDC
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Ishmael, C R
AU  - Ishmael CR
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Hsiue, P
AU  - Hsiue P
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Hori, K
AU  - Hori K
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Hornicek, F
AU  - Hornicek F
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
FAU - Eckardt, J J
AU  - Eckardt JJ
AD  - Department of Orthopaedic Surgery, University of California, Los Angeles, Los 
      Angeles, California, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Adult
MH  - *Bone Nails
MH  - Bone Neoplasms/diagnostic imaging/pathology/*surgery
MH  - Female
MH  - Femoral Neoplasms/diagnostic imaging/pathology/surgery
MH  - Follow-Up Studies
MH  - Humans
MH  - Humerus/diagnostic imaging/pathology/surgery
MH  - Limb Salvage/*methods
MH  - Male
MH  - Prospective Studies
MH  - *Prostheses and Implants
MH  - Prosthesis Failure
MH  - Tibia/diagnostic imaging/pathology/surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Complex revision
OT  - Endoprosthesis
OT  - Short intramedullary segment
EDAT- 2019/06/04 06:00
MHDA- 2019/06/08 06:00
CRDT- 2019/06/04 06:00
PHST- 2019/06/04 06:00 [entrez]
PHST- 2019/06/04 06:00 [pubmed]
PHST- 2019/06/08 06:00 [medline]
AID - 10.1302/0301-620X.101B6.BJJ-2018-0993.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2019 Jun;101-B(6):724-731. doi: 
      10.1302/0301-620X.101B6.BJJ-2018-0993.R1.