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Cited by 86Sarcoma Diagnosis and TreatmentBone Tumor Diagnosis and TreatmentsOrthopaedic implants and arthroplasty

Outcome of Expandable Prostheses in Children

Ruggieri, Pietro, Mavrogenis, Andreas F., Pala, Elisa, Romantini, Matteo, Manfrini, Marco, Mercuri, Mario·2013·Journal of Pediatric Orthopaedics
DOI 10.1097/bpo.0b013e318286c178
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Abstract

BACKGROUND: Expandable prostheses offer the advantages of limb-salvage and limb-length equality at skeletal maturity. However, what is the cost for achieving that goal, and in how many children this is achieved? MATERIALS AND METHODS: We present 32 children (16 boys and 16 girls; mean age, 9 y) with bone sarcomas of the femur treated with limb salvage using expandable prostheses. The Kotz Growing prosthesis and the noninvasive Repiphysis and Stanmore expandable prostheses were used. The mean follow-up was 49 months. Survival analysis of the children and primary implants and functional evaluation were performed. RESULTS: Survival of the children was 94% and 84% at 48 and 72 months. Survival of the primary prostheses was 78% and 66% at 48 and 72 months; survival was significantly higher only for the Kotz when compared with the Repiphysis prostheses (P=0.026). The rate of implant-related complications was 51.3%; 9 prostheses (23%) were revised because of aseptic loosening, infection, and breakage. A mean total lengthening of 28 mm (4 to 165 mm) was achieved by 84 procedures (2.6 procedures/patient). Three of the 9 children who reached skeletal maturity had limb-length equality and 6 discrepancy of 15 to 30 mm. The mean Musculoskeletal Tumor Society score was excellent (79%) without a significant difference between the type of prostheses (P=0.934). CONCLUSIONS: The Kotz Growing prosthesis, although it requires an open lengthening procedure, has shown higher survival when compared with the noninvasive Repiphysis prosthesis. However, the total lengthening remains small, and the complications rates are high even with the noninvasive prostheses.

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  • Minimally invasive and non-invasive growing implants enable limb-salvage reconstruction and future limb-length equality for patients with skeletal immaturity.

    “Minimally invasive and non-invasive growing implants enable limb-salvage reconstruction as well as future limb-length equality for patients with skeletal immaturity 135 .”

    From Osteosarcoma (2022) · cites this paper as [135]

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Authors
Ruggieri, P., Mavrogenis, A. F., Pala, E., Romantini, M., Manfrini, M., & Mercuri, M.
Affiliations
Istituto Ortopedico Rizzoli (IT)
ORCID
Venue
Journal of Pediatric Orthopaedics
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-04
Volume
33
Issue
3
Pages
244-253
ISSN
0271-6798 (ISSN-L)
DOI
10.1097/bpo.0b013e318286c178
OpenAlex
W2024296333
Cited by
86
References
59
Citations by year
2025: 7 · 2024: 3 · 2023: 3 · 2022: 8 · 2021: 13 · 2020: 2 · 2019: 12 · 2018: 6 · 2017: 9 · 2016: 5 · 2015: 4 · 2014: 10 · 2013: 3 · 2012: 1
FWCI
5.96
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Pediatric Orthopaedics (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Sarcoma Diagnosis and Treatment
  • Health Sciences › Medicine › Rheumatology › Bone Tumor Diagnosis and Treatments
  • Health Sciences › Medicine › Surgery › Orthopaedic implants and arthroplasty
Keywords
limb salvage, bone sarcoma, children, limb length discrepancy, skeletal maturity, implant survival, aseptic loosening, implant-associated infection, functional outcome
MeSH terms
Adolescent, Bone Lengthening, Child, Child, Preschool, Female, Femoral Neoplasms, Humans, Leg Length Inequality, Male, Prosthesis Design, Retrospective Studies, Osteosarcoma, Treatment Outcome, Prostheses and Implants, Limb Salvage

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