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J Knee Surg 2018; 31(09): 822-826
DOI: 10.1055/s-0037-1615298
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Patients with Revision Modern Megaprostheses of the Distal Femur Have Improved Disease-Specific and Health-Related Outcomes Compared to Those with Primary Replacements

Clémence Heyberger
1   Service de Chirurgie Orthopédique, Hôpital Cochin, Paris, France
,
Guillaume Auberger
1   Service de Chirurgie Orthopédique, Hôpital Cochin, Paris, France
,
Antoine Babinet
1   Service de Chirurgie Orthopédique, Hôpital Cochin, Paris, France
,
Philippe Anract
1   Service de Chirurgie Orthopédique, Hôpital Cochin, Paris, France
2   INSERM U1153, Paris, France
3   Université Paris Descartes, Paris, France
,
David J. Biau
1   Service de Chirurgie Orthopédique, Hôpital Cochin, Paris, France
2   INSERM U1153, Paris, France
3   Université Paris Descartes, Paris, France
› Author Affiliations
Funding None.
Further Information

Publication History

08 June 2017

21 September 2017

Publication Date:
21 December 2017 (online)

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Abstract

We asked whether there would be any difference between primary and revision modern cemented fixed hinge megaprosthesis of the distal femur in function and activity-related outcomes following treatment of a bone tumor. An identical custom-made fixed hinge cemented megaprosthesis with a hydroxyapatite collar was used in all cases. The main outcomes were joint-specific function, disease-specific activity, and health-related quality of life. Implant survival was also evaluated. Patients in the revision group performed slightly better than patients in the primary group on disease-specific (Toronto Extremity Salvage Score, p = 0.033; Musculoskeletal Tumor Society, p = 0.072) and health-related outcomes (Short Form 36 [SF-36] physical component, p = 0.085; SF-36 mental component, p = 0.069) but not on joint-specific outcomes (Knee Society Score, p = 0.94). The cumulative probabilities of revision for any reason were 14.5% (7–25%) at 5 years with no statistically significant difference between primary and revision procedures (p = 0.77). In conclusion, patients undergoing a revision have similar joint-specific functional outcome but improved disease-specific and health-related outcomes. Implant survival are similar between groups.

Keywords

megaprosthesis - revision - function - quality of life - survival

Note

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.