The Retrospective Study And Analysis Of The Survival Rate And Incidence Of Complications Related To Prosthesis And Surgery After Resection Of Bone Tumors And Custom-made Prosthesis Reconstruction

Objective:To retrospectively study the survival rate and incidence of complications related to prosthesis and surgery after resection of bone tumors and custom-made prosthesis reconstruction and to preliminarily analyze the reasons, discuss the factors on which we should focus during the surgery and peri-postoperative period.Data and methods:We retrospectively reviewed 126 patients who underwent resection of bone tumors and custom-made prosthesis reconstruction between 1996 and 2007. Survival rates and complications were observed. Average follow-up was 51 months (range:3-124 months). There are 78 male patients and 48 female.Grouping the patients by pathology:56 with osteosarcoma,40 with GCT(giant cell tumor of bone),12 with chondrosarcoma,8 with metastatic tumor,6 with malignancy fibrohistiocytoma,2 with Ewing sarcoma,1 with fibrosarcoma,1 with aneurismal bone cyst.Grouping the patients by the location:43 in distal femur,42 in proximal tibia,24 in proximal femur,7 in proximal humerus,9 in pelvis,1 in distal radius.Results:The prosthetic complications rate was 26.98% (34/126). Of 34 instances of complications,8/34 were loosening,7/34 breakage,6/34 dislocation,5/34 fracture,3/34 infection,3/34 nonunion,2/34 common peroneal nerve injury. The incidence of complications was 55.6%,28.6%,25.6%,20.8% and 14.2% in pelvis, proximal tibia, distal femur, proximal femur and proximal humerus respectively. According to operative site, the survival of total prosthesis is 80.5%in 3years,68.5% in 5years and 59.7% in 7 years.The 3 years overall prosthesis survival was 88.9% in proximal femur,86.6% in distal femur,70.0% in proximal tibia,75% in proximal humerus,77.7% in pelvis. The 5 years overall prosthesis survival was 76.2% in proximal femur,73.5% in distal femur,53.7% in proximal tibia,75% in proximal humerus,50% in pelvis. The 7 years overall prosthesis survival was 61% in proximal femur,58.8% in distal femur,48.8% in proximal tibia,75% in proximal humerus.21 complications ocurred in 3 years,3 in 3-5 years,10 after 5 years. Conclusion: Incidence of complications and survival was related to operative site and prosthesis type. The rank of incidence of complications is pelvis, proximal tibia, distal femur, proximal femur and proximal humerus from high to low. The rank of 5 years overall prosthesis survival was proximal femur, proximal humerus, distal femur, proximal tibia and pelvis from high to low. The incidence of complications relatively concentrated in less than 3 years and more than 5 years after operation.