DOI: https://doi.org/10.15674/0030-59872019267-73

Proximal tibia modular endoprosthetic replacement. Analysis of complications

Oleg Vyrva, Ivan Skoryk, Igor Shevchenko, Roman Malyk, Yanina Golovina, Dmytro Mikhanovskiy

Abstract


The reconstruction of proximal tibial by using modular endoprosthetics is a complex surgical procedure, accompanied by a significant number of complications (40–70 %) in the period of follow up of 5–15 years.

Objective: to analyze the primary complications of modular endoprosthetic reconstruction of proximal tibial.

Methods: the results of surgical interventions performed on 47 patients with PT tumor lesions (20 men (42.6 %) and 27 women (57.4 %), age from 12 to 74 years) were evaluated. The patients were divided into two groups: I (35 people) — primary modular endoprosthetics after removal of the tumor, II (12) — revision.

Results: in the period from 3 weeks to 13 years after the establishment of a modular endoprosthesis due to complications, 18 (38.2 %) patients underwent revision surgeries. The implanted endoprosthesis was removed in 12 cases (25.5 %): in group I — 9 (25.7 %), in II — 3 (25 %). Due to tumor recurrence, 2 (4.26 %) myofascioplastic amputations were performed. Complications associated with the insufficiency of soft tissues (type I) were observed in 3 (6.3 %) people: in group I — 1 (7.6 % of all complications in the group), in II — 2 (40 %). Aseptic instability (type II) was detected in one case of group I (7.6 % of all group complications) 6 years after primary endoprosthesis. Periprosthetic infection (type IV) developed in periods from 12 days to 4 years in 12 patients (70 % of all complications): in group I — 9 (52.9 %), in II — 3 (17.6 %). Local recurrence of a tumor lesion (V type) was detected in 2 (11.7 % of all complications) people of group I after 6 months. and 3 years after surgery.

Conclusions: in patients with malignant tumors of proximal tibial, the technique of replacing post-resection defects with modular endoprostheses is justified, since it provides 61.8 % positive results.


Keywords


modular endoprosthetics; proximal tibial region; complications of modular endoprosthetic reconstruction proximal

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