Convened under the auspicious of esteemed endorsers - ISTA

*Pietro Ruggieri - University of Bologna, Istituto Rizzoli - Bologna, ItalyElisa Pala - University of Bologna, Istituto Rizzoli - Bologna, ItalyAndrea Angelini - University of Bologna, Istituto Rizzoli - Bologna, Italy*Email: pietro.ruggieri@ior.itPurpose of this study is to analyze the results of a modular reconstructive tumor prosthesis forthe lower limb (GMRS ® ) with a comparative statistical analysis of primary and secondaryimplants.Material and methods From October 2003 to September 2007 at Rizzoli 161 GMRS ®prostheses were implanted, most after resection of osteosarcoma (94 cases, 58%). It is amodular system with a rotating hinge mechanism for the knee, cemented and uncementedstems, in titanium and chromium-cobalt-molybdenum, curved and straight-fluted, with orwithout hydroxyapatite coating. Moreover adaptors are available to revise HMRS ® implants.This series includes 88 males and 73 females ranging in age from 9 to 80 years. Sites ofreconstruction were 109 distal femurs, 19 proximal femurs, 1 total femur and 32 proximal tibias.There were 149 oncologic and 12 non oncologic diagnoses, including 96 primaryreconstructions and 65 revisions after failure of previous implant. A retrospective analysis ofimaging and complications was performed and functional results assessed according to MSTSsystem. Statistical analysis with Kaplan-Meier curves was used to study implant survival.Results At a mean follow up of 2 yrs. 106 patients are continuously NED, 31 are NED aftertreatment of one or more local recurrence or metastasis, 7 AWD, 5 DWD. There were 10 majorcomplications: 8 infections (4,7%) (5 in primary and 3 in secondary implants, 2 previouslyinfected) and 2 aseptic loosening (1,2%) (1 each). There were 9 minor complications (4 woundsloughs, 1 stiff joint, 3 disrupted extensor apparatus,1 patellar instability) requiring revision.Comparative statistical analysis of primary and secondary implants survival at majorcomplications shows no statistically significant difference. Functional results were good orexcellent in 95% of the evaluated patients, without any poor.Conclusions Middle term results are promising: good function, very low incidence of majorcomplications, no breakage of implant components. This prosthetic reconstruction is indicatedin oncological cases as well as in selected in some non oncological settings, such as challengingrevisions of prosthetic failures with massive bone loss or post-radiation non unions or allograftsfailures. Although a higher incidence of complications was expected in secondary implants,statistical analysis shows similar survival.References 1Mittermayer F et Al. Long-term followup of uncemented tumor endoprostheses forthe lower extremity. Clin Orthop 2001;2Gosheger G et Al. Endoprosthetic reconstruction in 250patients with sarcoma. Clin Orthop 2006;3Ruggieri P et Al. A new modular prosthesis (GMRS-Stryker) for reconstruction of the lower limb after resection: preliminary results in 94 cases.14th ISOLS, Hamburg 2007.Friday, October 8, 2010, 7:30-8:30Session B9: Complications in Arthroplastyfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]