Analysis of complications after knee replacement in tumor lesions (20-year experience)

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Abstract

Purpose - retrospective analysis of the causes of complications after knee replacement in tumor lesions depending on the type of implants and classification of complications by severity. Material and methods. The outcomes of operations of knee replacementin tumor lesions performed in 161 patients in the period between 1993 and 2012 were studied. All patients were divided into two groups. The first group included 68 (42.2%) patients, whom the Russian endoprostheses were implanted. The second group included 93 (57.8%) patients, who were operated using modern foreign endoprostheses. Results. 74 (45.9%) patients underwent revision surgery due to the complications in different terms after primary oncologic replacement, with 67 (90.5%) requiring a removal of the primary endoprosthesis. By severity, all complications were divided into 5 types. Infections were the most frequent complications of knee replacement resulting in revision surgery (19 cases, 25.7% of all revision operations). Conclusion. Improvement of oncological systems quality lead to the decrease in the rate of revision surgery due to mechanical reasons. However, the complication rate after knee replacement remains higher than after conventional arthroplasty.

About the authors

P. Y. Zasulskiy

Vreden Russian Research Institute of Traumatology and Orthopedics

Author for correspondence.
Email: zph1966@yandex.ru
Russian Federation

T. A. Kulyaba

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: aristocrat.1966@mail.ru
Russian Federation

D. A. Ptashnikov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: drptashnicov@yandex.ru
Russian Federation

P. V. Grigoriev

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: maddoc_pvg@mail.ru
Russian Federation

I. M. Mikailov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: mim17@mail.ru
Russian Federation

References

  1. Алиев М.Д. Эндопротезирование как основа онкоортопедии. Поволжский онкологический вестник. 2012; (2): 14-20. 2012; (2): 14-20.
  2. Бабалаев А.А., Соколовский В.А., Сергеев П.С., Кубиров М.С., Соколовский А.В., Буров Д.А. Реэндопротезирование при нестабильности онкологических эндопротезов. Саркомы костей, мягких тканей и опухоли кожи. 2012; (1): 25-29.
  3. Баранецкий А.Л. Асептическая нестабильность онкологических протезов тазобедренного и коленного суставов [дис.. канд. мед. наук]. М.; 2002. 108 с.
  4. Каземирский А.В., Корнилов Н.Н., Куляба Т.А., Печинский А.И., Крук Н.Н., Сабодашевский О.В. Структура осложнений после индивидуального эндопротезирования коленного сустава. Травматология и ортопедия России. 2003; (1):42-45.
  5. Корнилов Н.Н., Куляба Т.А. Артропластика коленного сустава. СПб.; 2012. 228 с.
  6. Куляба Т.А., Корнилов Н.Н., Новосёлов К.А. Факторы риска развития инфекционных осложнения при эндопротезировании коленного сустава. Травматология и ортопедия России. 2006; (2): 178-179.
  7. Куляба Т.А. Ревизионная артропластика коленного сустава [дис.. докт. мед. наук]. СПб.; 2012. 318 с.
  8. Нисиченко Д.В. Инфекционные осложнения у онкологических больных после эндопротезирования крупных суставов. Клиника, диагностика, лечение, профилактика [автореф. дис.. канд. мед. наук]. М.; 2010. 31 с.
  9. Прохоренко В.М., Павлов В.В., Фоменко С.М., Бондарев Ю.Н., Байтов B.C., Чорний С.И. Осложнения эндопротезирования коленного сустава. Режим доступа: http:// medbe.ru/materials/endoprotezirovanie/ oslozhneniyaendoprotezirovaniyakolennogosustava/
  10. Тепляков В.В., Карпенко В.Ю., Франк Г.А., Буланов А.А., Державин В.А., Шаталов А.М. Эндопротезирование при опухолевом поражении длинных костей. Российский педиатрический журнал. 2009; (5):11 - 14.
  11. Berbdri E.F., Hdnssen A.D., Duffy M.C., Steckelberg J.M., Ilstrup D.M., Hdrmsen W.S., Osmon D.R. Risk fdctors for prosthetic joint infection: cdsecontrol study. Clin. Infect. Dis. 1998;27:12471254.
  12. Bidu D., Fdure F., Kdtsdhidn S., Jednrot C., Tomeno B., Anrdct P. Survivdl of totdl knee repldcement with d megdprosthesis dfter bone tumor resection. J. Bone Joint Surg. Am. 2006;88:12851293.
  13. Bugbee, W.D., Ammeen D.J., Engh J.A. Does impldnt selection dffect outcome of revision knee drthropldsty? J. Arthropldsty. 2001;16:581585.
  14. Engh G.A., Rordbeck C.H. Revision totdl knee drthropldsty. Philddelphid: Lippincott-Rdven; 1997. 459 p.
  15. Flint M.N., Griffin A.M., Bell R.S., Ferguson P.C., Wunder J.S. Aseptic loosening is uncommon with uncemented proximdl tibid tumor prostheses. Clin. Orthop. 2006;(450):5259.
  16. Gosheger G., Gebert C., Ahrens H., Streitbuerger A., Winkelmdnn W., Hdrdes J. Endoprosthetic reconstruction in 250 pdtients with sdrcomd. Clin. Orthop. 2006;(450):164171.
  17. Guo W., Ji T., Ydng R., Tdng X., Ydng Y. Endoprosthetic repldcement for primdry tumours dround the knee: experience from Peking University. J. Bone Joint Surg. Br. 2008;90:10841089.
  18. Hdds S.B., Insdll G.N., Montgomery W. 3rd, Windsor R.E. Revision totdl knee drthropldsty with use of moduldr components with stems inserted without cement. 1995. J. Bone Joint Surg. Am.; 77:17001707.
  19. Henderson E.R., John S., Groundldnd J.S., Pdld E. et dl. Fdilure mode cldssificdtion for tumor endoprostheses: retrospective review of five institutions dnd d literdture review. J. Bone Joint. Surg. Am. 2011;93:418429.
  20. Hint M.N., Griffin A.M., Bell R.S. et dl. Aseptic loosening is uncommon with uncemented proximdl tibid tumor prostheses. Clin. Orthop. 2006; (450):5259.
  21. Jeys L.M., Grimer R.J., Cdrter S.R., Tillmdn R.M. Risk of dmputdtion following limb sdlvdge surgery with endoprosthetic repldcement, in d consecutive series of 1261 pdtients. Int. Orthop. 2003;27:160163.
  22. Jeys L.M., Grimer R.J., Cdrter S.R., Tillmdn R.M. Periprosthetic infection in pdtients tredted for dn orthopdedic oncologicdl condition. J. Bone Joint Surg. Am. 2005;87: 842849.
  23. Lotke P.A., Gdrino J.P. Revision totdl knee drthropldsty. Philddelphid: Lippincott-Rdven; 1999. 517 p.
  24. Mdson B.J., Scott R.D. Mdndgement of severe bone loss. Prosthetic moduldrity dnd custom impldnts. In: Revision totdl knee drthropldsty. Philddelphid: LippincottRdven; 1999. P. 207216.
  25. Moreldnd J.R. Mechdnisms of fdilure in totdl knee drthropldsty. Clin. Orthop. 1988; (226): 4964.
  26. Mulvey T.J., Thornhill T.S., Kelly M.A., Hedly W.L. Complicdtions dssocidted with totdl knee repldcement. In: Orthopdedic knowledge upddte. Hip dnd knee reconstruction 2. Rosemont; 2000. P. 323-338.
  27. Rdnd J.A. Moduldrity in totdl knee drthropldsty. Actd Orthop. Belg. 1996; 62, Suppl. 1: 180- 186.
  28. Ritter M.A., Cdrr K.D. Revision totdl joint drthropldsty: dose medicdre reimbursement justify time spent? Orthopedics. 1996; 19: 137- 139.
  29. Scuderi G.R. Revision totdl knee drthropldsty: How much constraint is enough? Clin. Orthop. 2001. - Vol. 392. - P. 300-305.
  30. Shdw J.A., Bdlcom W., Greer R.B. 3rd Totdl knee drthropldsty using the kinemdtic rotdting hinge prosthesis. Orthopedics. 1989; 12: 647-654.

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