Long-term outcomes and improved risk of revision following tumor endoprosthetic replacement of the distal femur: Single institutional results

Charles A Gusho; Joshua A Greenspoon; Bishir Clayton; Jonathan Bauer; Matthew W Colman; Steven Gitelis; Alan T Blank

doi:10.1016/j.jor.2021.05.027

Long-term outcomes and improved risk of revision following tumor endoprosthetic replacement of the distal femur: Single institutional results

J Orthop. 2021 May 21:25:259-264. doi: 10.1016/j.jor.2021.05.027. eCollection 2021 May-Jun.

Authors

Charles A Gusho¹, Joshua A Greenspoon¹, Bishir Clayton¹, Jonathan Bauer¹, Matthew W Colman¹, Steven Gitelis¹, Alan T Blank¹

Affiliation

¹ Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Abstract

Purpose: This study assessed revision characteristics following distal femur tumor endoprosthetic replacement.

Methods: Fifty-seven procedures were performed between 2005 and 2019. The cumulative incidence of implant revision was calculated with death as a competing risk.

Results: The all-cause revision rate was 21.1% (n = 12) at a mean 65.3 ± 47.3 months. Competing risk analysis revealed a cumulative revision incidence of 12.0% (95% CI, 3.6-25.9%) at five years and 36.5% (95% CI, 12.8-61.0%) at ten years.

Conclusions: We provide an accurate assessment of revision risk which is slightly lower than historical controls, with identification of failure modes to reliably inform patient expectations.

Level of evidence: III. Retrospective Study.

Keywords: Bone tumor; Distal femur; Revision; Tumor endoprosthesis.