Long-Term Results of Kyocera Modular Limb Salvage System after Resection of Tumors in the Distal Part of the Femur: Report from Japanese Musculoskeletal Oncology Group Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Procedure for Tumor Resection
2.3. Prosthesis
2.4. Reconstruction
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Parameter | N |
---|---|---|
Age (years) | Mean | 35 |
Range | 9–79 | |
Sex (N) | Male | 59 |
Female | 66 | |
Perioperative cx (N) | Yes | 84 |
No | 41 | |
Femoral stem fixation (N) | cement-type | 52 |
cementless-type | 73 | |
Femoral component (N) | 90 mm | 7 |
110 mm | 19 | |
130 mm | 23 | |
150 mm | 30 | |
170 mm | 19 | |
190 mm | 8 | |
>210 mm | 19 | |
Stem length (N) | 130 mm | 120 |
170 mm | 5 | |
TLP/SL (ratio) | 1.65–3.23 | |
Stem diameter (N) | cement-type | |
10 mm | 4 | |
11 mm | 26 | |
12 mm | 12 | |
13 mm | 10 | |
cementless-type | ||
10 mm | 1 | |
11 mm | 1 | |
12 mm | 46 | |
13 mm | 14 | |
14 mm | 7 | |
15 mm | 4 |
Complications | N |
---|---|
Aseptic loosening | 15 |
Stem breakage | 14 |
Infection | 13 |
Rotator-hinge bushing failure | 13 |
Local recurrence | 5 |
Fracture | 2 |
Others | 3 |
Variables | N | Implant Survival Rate (%) | ||||
---|---|---|---|---|---|---|
5-Years | 10-Years | 15-Years | p Value | |||
Age | <20 years | 52 | 71.2 | 60.9 | 37.3 | 0.96 |
(56.8–81.5) | (46.1–72.8) | (22.1–52.6) | ||||
>20 years | 73 | 72.5 | 56.2 | 42.9 | ||
(60.7–81.3) | (43–67.5) | (27.8–57.2) | ||||
BMI | >25 kg/m2 | 13 | 61.5 | 41 | 41 | 0.93 |
(30.8–81.8) | (8.5–72.5) | (8.5–72.5) | ||||
<25 kg/m2 | 83 | 71.4 | 58.1 | 35.6 | ||
(60.4–79.8) | (46.2–68.3) | (21.8–49.7) | ||||
Sex | Male | 59 | 71.1 | 57.5 | 41.2 | 0.73 |
(57.7–80.9) | (43.5–69.3) | (25.7–56) | ||||
Female | 66 | 72.7 | 59.3 | 37.5 | ||
(60.3–81.9) | (45.7–70.6) | (22.1–52.8) | ||||
Perioperative | Yes | 83 | 68.6 | 56 | 33.1 | 0.18 |
(57.4–77.4) | (44.2–66.2) | (19.9–46.9) | ||||
chemotherapy | No | 42 | 78.6 | 63.9 | 52.1 | |
(62.9–88.2) | (46.4–77) | (33.7–67.7) | ||||
Patella | Yes | 21 | 66.7 | 55.4 | 47.5 | 0.92 |
(42.5–82.5) | (31.4–74) | (23.3–68.3) | ||||
replacement | No | 104 | 73.1 | 59.3 | 37.2 | |
(63.4–80.6) | (48.7–68.4) | (24.8–49.7) | ||||
Resection of | Extra-capsule | 21 | 66.3 | 63.4 | 41.6 | 0.11 |
(42–82.3) | (52.4–72.5) | (28.3–54.4) | ||||
Joint | Intra-capsule | 94 | 72.3 | 38.3 | 38.3 | |
(62.1–80.2) | (17.1–59.3) | (17.1–59.3) | ||||
Resection | 3 to 4 | 12 | 66.7 | 57.1 | 28.6 | 0.83 |
(33.7–86) | (25.4–79.6) | (4.9–59.4) | ||||
of quadriceps femoris | 0 to 2 | 96 | 71.8 | 58.9 | 41.4 | |
(61.7–79.7) | (47.8–68.4) | (28.4–53.8) | ||||
Fixation of | Cementless | 73 | 76.7 | 55.7 | 35.3 | 0.82 |
(65.2–84.8) | (42.9–66.8) | (21.7–49.3) | ||||
femoral stem | Cement | 52 | 65.2 | 63.1 | 46.4 | |
(50.6–76.5) | (48.3–74.6) | (28.8–62.4) |
Ref | N | Stem | Hinge | Implant survival | Complications | ||||
---|---|---|---|---|---|---|---|---|---|
Fixation | Type | 5-years | 10-years | 15-years | Loosening | Infection | F-stem b | ||
[8] | 152 | C | modular; RH | 74% * | 59% * | 50% * | 21% | 9.9% | 2% |
custom; FH | |||||||||
[9] | 669 # | C 9% | FH | 80% * | 5.7% | 8.2% | 4.4% | ||
C-less 91% | |||||||||
[10] | 69 | C-less | RH | 73% * | 65% * | 55% * | 13% | 7.2% | 4.3% |
[11] | 335 | C 53% | FH; 48% | 83% * | 67% * | 51% * | 9.6% | 2.1% | |
C-less 47% | RH; 52% | ||||||||
[12] | 93 | C | RH | 73.3% * | 62.8% * | 4.9% | 11.7% | 5.8% | |
Ours | 125 | C 42% | RH | 72.8% * | 64.9% * | 46.3% * | 12% | 10.4% | 11.2% |
C-less 58% | (72% **) | (58.5% **) | (39.4% **) |
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Nakamura, T.; Matsumine, A.; Toda, Y.; Takenaka, S.; Outani, H.; Fujiwara, T.; Nishida, Y.; Tsukushi, S.; Tome, Y.; Kawamoto, T.; et al. Long-Term Results of Kyocera Modular Limb Salvage System after Resection of Tumors in the Distal Part of the Femur: Report from Japanese Musculoskeletal Oncology Group Study. Cancers 2022, 14, 870. https://doi.org/10.3390/cancers14040870
Nakamura T, Matsumine A, Toda Y, Takenaka S, Outani H, Fujiwara T, Nishida Y, Tsukushi S, Tome Y, Kawamoto T, et al. Long-Term Results of Kyocera Modular Limb Salvage System after Resection of Tumors in the Distal Part of the Femur: Report from Japanese Musculoskeletal Oncology Group Study. Cancers. 2022; 14(4):870. https://doi.org/10.3390/cancers14040870
Chicago/Turabian StyleNakamura, Tomoki, Akihiko Matsumine, Yu Toda, Satoshi Takenaka, Hidetatsu Outani, Tomohiro Fujiwara, Yoshihiro Nishida, Satoshi Tsukushi, Yasunori Tome, Teruya Kawamoto, and et al. 2022. "Long-Term Results of Kyocera Modular Limb Salvage System after Resection of Tumors in the Distal Part of the Femur: Report from Japanese Musculoskeletal Oncology Group Study" Cancers 14, no. 4: 870. https://doi.org/10.3390/cancers14040870