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Lari A, Esmaeil A, AlSalem Y, Alabbad F, Shahin M, Aoude A. Comparative Outcomes and Failure Rates of Total Femur Replacement in Oncologic and Nononcologic Indications: A Systematic Review and Meta-analysis. JBJS Rev 2024; 12:01874474-202407000-00001. [PMID: 38968379 PMCID: PMC11221795 DOI: 10.2106/jbjs.rvw.24.00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
BACKGROUND Total femur replacement (TFR) has become increasingly significant as a salvage procedure for both oncologic reconstruction and complex nononcologic conditions such as revision arthroplasty. Despite its effectiveness in limb salvage, TFR is associated with high complication and failure rates, which vary depending on the underlying indication. METHODS This systematic review and meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of MEDLINE, EMBASE, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was conducted, focusing on studies that reported outcomes of TFR in oncologic and nononcologic cases. Primary outcomes included failure mode and rates according to the Henderson classification, functional outcomes scores, and mobility status. Data were analyzed using random-effects models and generalized linear mixed models. RESULTS A total of 35 studies involving 1,002 patients were included. The majority of TFRs were performed for oncologic reasons (63.7%). The mean Musculoskeletal Tumor Society (MSTS) score was 66%, with a limb salvage rate of 89%. The meta-analysis revealed a combined failure rate of 34%. For type 4 failures (infection), nononcologic patients exhibited a significantly higher rate at 18% (95% confidence interval [CI], 12%-26%, I2 = 46%, p < 0.01) compared with 8% in oncologic patients (95% CI, 6%-12%, I2 = 0%). Regarding combined types 1 to 4 failures, oncologic patients had a rate of 20% (95% CI, 25%-52%, I2 = 60%), whereas nononcologic patients faced a higher rate of 37% (95% CI, 12%-26%, I2 = 63%) (p < 0.05), indicating a significant difference. There were no significant differences in the MSTS score. In addition, there were no notable differences when comparing failure modes 1, 2, and 3 independently. Mobility analysis showed that approximately 70% of patients required walking aids after surgery. CONCLUSION TFR offers a valuable limb salvage option in both oncologic and nononcologic scenarios, despite its high failure rates. Although functional outcomes were similar between groups, the higher failure rate in nononcologic cases and the poor overall quality of evidence warrant further comprehensive assessments into predictors of outcomes to optimize results. LEVEL OF EVIDENCE Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ali Lari
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Ali Esmaeil
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Yousef AlSalem
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Fahad Alabbad
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Maged Shahin
- Department of Orthopedic Surgery, AlFarwaniya Hospital, Kuwait
| | - Ahmed Aoude
- McGill University Health Centre, Montreal, Quebec, Canada
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2
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Murray J, Jeyapalan R, Davies M, Sheehan C, Petrie M, Harrison T. Total femoral arthroplasty for non-oncological indications. Bone Joint J 2023; 105-B:888-894. [PMID: 37524348 DOI: 10.1302/0301-620x.105b8.bjj-2022-1372.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Aims Total femoral arthroplasty (TFA) is a rare procedure used in cases of significant femoral bone loss, commonly from cancer, infection, and trauma. Low patient numbers have resulted in limited published work on long-term outcomes, and even less regarding TFA undertaken for non-oncological indications. The aim of this study was to evaluate the long-term clinical outcomes of all TFAs in our unit. Methods Data were collected retrospectively from a large tertiary referral revision arthroplasty unit's database. Inclusion criteria included all patients who underwent TFA in our unit. Preoperative demographics, operative factors, and short- and long-term outcomes were collected for analysis. Outcome was defined using the Musculoskeletal Infection Society (MSIS) outcome reporting tool. Results Overall, 38 TFAs were identified. The mean age was 73 years (42 to 80). All patients underwent TFA for non-oncological indications, most commonly as a consequence of infection (53%) and periprosthetic fracture (26%). The mean follow-up time was ten years (0 to 26); 63% of TFAs were considered a success based upon the MSIS outcome reporting tool. The mean time between TFA and death was 8.5 years (0.2 to 19.2), with two patients dying within one year of surgery. Within the cohort, 66% suffered at least one complication, dislocation being most common (37%); 55% of the total cohort required at least one subsequent operation. In total, 70% of TFAs undertaken for infection were considered infection-free at time of final follow-up. The percentage of mobile patients improved from 52% to 65% between pre- and postoperation, with all patients being able to at least transfer from bed to chair at time of final review. Conclusion This study is the largest in the UK assessing the use of TFA in patients with bone loss secondary to non-oncological conditions. It demonstrates that TFA has a significant complication profile, however it is favourable in terms of mortality and rehabilitation when compared to amputation and disarticulation.
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Affiliation(s)
- James Murray
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Rathan Jeyapalan
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Michael Davies
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Ciara Sheehan
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Michael Petrie
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tim Harrison
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Adzhar AL, Faisham WI, Zulmi W, Azman WS, Sahran Y, Syurahbil AH, Nor-Azman MZ. Long-term Outcome of Total Femur Replacement. Malays Orthop J 2023; 17:21-27. [PMID: 37583532 PMCID: PMC10425001 DOI: 10.5704/moj.2307.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/02/2022] [Indexed: 08/17/2023] Open
Abstract
Introduction Total femur replacement is an option instead of amputation for extensive bone tumour or after revision surgery with a massive bone loss. Over a long period of time the patients may need revision surgery, and this might affect the functional outcome. We reviewed all consecutive total femur replacements done for primary and revision surgery of primary bone tumours in our centre to evaluate the long-term functional outcome and survival. Materials and methods All patients who had total femur resection and reconstruction with modular endoprosthesis replacement in our centre from June 1997 to May 2022 were reviewed. The respondents were surveyed through WhatsApp using google form which was translated into Bahasa Malaysia based on the Musculoskeletal Tumour Society Scoring System (MSTS). The data were presented as descriptive data on the final survival of the limb and prosthesis. Results Ten patients underwent total femur replacement. There were eight osteosarcoma, one giant cell tumour and one chondromyxoid fibroma. Three patients with osteosarcoma succumbed to pulmonary metastases; all had good early post-operative functional outcomes without local recurrence. Seven patients were available for long term evaluation of function with a mean follow-up of 17.6 years (ranged 10-25 years). Four patients with total femur replacement had good functional outcomes (60-80%) without revision with 10-25 years follow-up. Three patients experienced acetabulum erosion and chronic pain that required early hip replacements. Two of them were complicated with superior erosions and bone loss and subsequently were managed with massive reconstruction using cemented acetabulum cage reconstruction. The other has diabetes mellitus with chronic infection following revision of distal femur endoprosthesis to total femur replacement and subsequently underwent limited hemipelvectomy after 14 years. Conclusion Total femur replacement offers a good long term functional outcome and prosthesis survival and is a favourable option for limb salvage surgery.
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Affiliation(s)
- A L Adzhar
- Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - W I Faisham
- Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - W Zulmi
- Department of Orthopaedics, Prince Court Medical Centre, Kuala Lumpur, Malaysia
| | - W S Azman
- Department of Plastic Surgery, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Y Sahran
- Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - A H Syurahbil
- Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - M Z Nor-Azman
- Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Wu F, Fang X, Yuan D, Xiong Y, Luo Y, Zhang W, Tu C, Duan H. Preserving the rectus femoris and improving limb function after total femoral prosthesis replacement following resection of femoral malignant tumors. Front Oncol 2023; 13:1149342. [PMID: 36998467 PMCID: PMC10043403 DOI: 10.3389/fonc.2023.1149342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundCurrent research is focused on the factors that influence the maintenance of limb function after total femoral replacement. This retrospective study investigated the difference in functional outcomes in patients with invasion of the rectus femoris vs. an intact rectus femoris that underwent total femoral replacement with a modular total femur prosthesis.MethodsThe medical records of patients who underwent total femoral replacement with a modular total femur prosthesis between July 2010 and March 2017 at our institute were retrospectively reviewed. The patients were divided into two groups: group A had invasion of the rectus femoris and group B had an intact rectus femoris. Functional status was assessed using the Musculoskeletal Tumor Society Rating Scale (MSTS) and the Harris Hip Score (HHS). Complications were assessed using the International Society of Limb Salvage classification that was published in 2011 and modified in 2014.ResultsThe mean total MSTS score (23.0 ± 4.8 vs. 17.6 ± 3.1; P = 0.02) and the mean total HHS score (80.17 ± 6.24 vs. 55.38 ± 13.30; P = 0.001) were significantly higher in patients with intact rectus femoris compared with patients with invasion of the rectus femoris. Patients with an intact rectus femoris achieved significantly better limb function (support and gait) and active range of motion (P < 0.05). The overall complication rate was 35.7%.ConclusionsFunctional outcomes after total femoral replacement were significantly better in patients with an intact rectus femoris compared with patients with invasion of the rectus femoris, possibly because more muscle mass can be preserved around the femur in patients with an intact rectus femoris.
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Affiliation(s)
- Fan Wu
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Department of Orthopedics, Zigong Fourth People’s Hospital, Zigong, China
| | - Xiang Fang
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Dechao Yuan
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Yan Xiong
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Yi Luo
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Wenli Zhang
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Chongqi Tu
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Hong Duan
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Hong Duan,
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Mondanelli N, Troiano E, Facchini A, Ghezzi R, Di Meglio M, Nuvoli N, Peri G, Aiuto P, Colasanti GB, Giannotti S. Treatment Algorithm of Periprosthetic Femoral Fracturens. Geriatr Orthop Surg Rehabil 2022; 13:21514593221097608. [PMID: 35573905 PMCID: PMC9096211 DOI: 10.1177/21514593221097608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction. The ever-expanding indications for total hip arthroplasty are leading to more implants being placed in younger as well as in older patients with high functional demand. Also, prolonged life expectancy is contributing to an overall increment of periprosthetic femoral fractures. The Vancouver classification has been the most used for guiding the surgeon choice since its proposal in 1995. Fractures occurring over a hip femoral implant can be divided into intra-operative and post-operative PFFs, and their treatment depends on factors that may severely affect the outcome: level of fracture, implant stability, quality of bone stock, patients’ functional demand, age and comorbidities, and surgeon expertise. There are many different treatment techniques available which include osteosynthesis and revision surgery or a combination of both. The goals of surgical treatment are patients’ early mobilization, restoration of anatomical alignment and length with a stable prosthesis and maintenance of bone stock. Significance. The aim of this review is to describe the state-of-the-art treatment and outcomes in the management of PFFs. We performed a systematic literature review of studies reporting on the management of PFFs around hip stems and inter-prosthetic fractures identifying 45 manuscripts eligible for the analysis. Conclusions. PFFs present peculiar characteristic that must be considered and special features that must be addressed. Their management is complex due to the extreme variability of stem designs, the possibility of having cemented or uncemented stems, the difficulty in identifying the “real” level of the fracture and the actual stability of the stem. As a result, the definition of a standardized treatment is unlikely, thereby high expertise is fundamental for the surgical management of PPFs, so this kind of fractures should be treated only in specialized centres with both high volume of revision joint arthroplasty and trauma surgery.
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Affiliation(s)
- Nicola Mondanelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
| | - Elisa Troiano
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
| | - Andrea Facchini
- Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia, Italy
| | - Roberta Ghezzi
- Ospedale Santa Maria degli Angeli, Azienda Sanitaria Friuli Occidentale, Italy
| | - Martina Di Meglio
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
| | - Nicolò Nuvoli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
| | - Giacomo Peri
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
| | - Pietro Aiuto
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
| | - Giovanni Battista Colasanti
- Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy.,Ospedale Santa Maria delle Croci, Azienda USL della Romagna, Italy
| | - Stefano Giannotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.,Section of Orthopedics, Policlinico Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria Senese, Italy
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Viola DCM, Rodrigues Neto HR, Garcia JG, Petrilli MDT, Carlesse FADMC, Jesus-Garcia Filho R. Risk Factors Related to Poor Outcomes in the Treatment of Non-conventional Periprosthetic Infection. Rev Bras Ortop 2021; 56:615-620. [PMID: 34733433 PMCID: PMC8558934 DOI: 10.1055/s-0041-1731354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/08/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives
To identify the main risk factors related to poor outcomes after the treatment for periprosthetic infection.
Materials and Methods
Medical records from 109 patients who underwent non-conventional endoprosthesis surgeries (primary and revision procedures) from January 1, 2007, to December 31, 2018, were retrospectively evaluated. In total, 15 patients diagnosed with periprosthetic infection were eligible to participate in the study. Variables including gender, age at diagnosis, affected bone, surgery duration, white blood cell (WBC) count before endoprosthesis placement, urinary tract infection during the first postoperative year, and time elapsed from endoprosthesis placement to infection diagnosis were related to outcomes using the Fisher exact test (for the bicategorical variables) or analysis of variance (ANOVA, for the tricategorical variables). The mean times from diagnosis to final outcome were compared using the Student
t
-test.
Results
These risk factors did not show a statistically significant correlation with the outcomes. The data revealed a trend towards a difference between the mean time for the onset of infection and the final outcome. Due to the limited sample, we believe that studies with larger cohorts can prove this trend.
Conclusion
We identified that the time from endoprosthesis placement to the onset of the symptoms of infection tends to be related to the outcome and evolution of the patient evolution during the treatment for periprosthetic infection. Although apparently correlated, other associated factors were not statistically linked to poor treatment outcomes.
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Affiliation(s)
- Dan Carai Maia Viola
- Instituto de Oncologia Pediátrica (IOP/GRAACC), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.,Programa de Ortopedia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
| | - Henrique Ribeiro Rodrigues Neto
- Instituto de Oncologia Pediátrica (IOP/GRAACC), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | - Jairo Greco Garcia
- Instituto de Oncologia Pediátrica (IOP/GRAACC), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | - Marcelo de Toledo Petrilli
- Instituto de Oncologia Pediátrica (IOP/GRAACC), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
| | - Fabianne Altruda de Moraes Costa Carlesse
- Departamento de Pediatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.,Instituto de Oncologia Pediátrica (IOP), Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), São Paulo, SP, Brasil
| | - Reynaldo Jesus-Garcia Filho
- Instituto de Oncologia Pediátrica (IOP/GRAACC), Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil.,Programa de Ortopedia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
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Memon N, Iqbal F, Noor SS, Najjad KR, Sozera MF, Abro A, Khan N. Mid-term results and survival rates following a single-design rotating hinge knee arthroplasty in non-tumor conditions in a Pakistani population. Knee Surg Relat Res 2021; 33:15. [PMID: 33947473 PMCID: PMC8097908 DOI: 10.1186/s43019-021-00102-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Information regarding the use of hinged implants in non-oncological conditions is limited in our region due to a lack of adequate data collection and follow-up. The purpose of this study is to evaluate mid-term results and risk factors affecting the survivorship of third-generation rotating hinge knee (RHK) patients in non-oncological conditions. METHODS We retrospectively reviewed 41 single, third-generation, rotating hinge prostheses in three complex primary knee procedures and 38 revision knee surgeries in between 2007 to 2014. Implant survival was assessed using the Kaplan-Meier method. Factors influencing implant survival were identified using the log-rank test. During the study period, clinical results along with complications were assessed. Clinical outcomes were assessed by using the Knee Society Score (KSS). RESULTS RHK arthroplasty was used in 41 patients. Out of 41 patients, a RHK was used in three patients with a complex primary deformed knee whereas in 38 patients, a RHK was used in revision arthroplasty surgery. The cumulative implant survival rate with re-revision due to any cause was found to be 87.8% (95% CI 69.2-90.1) at 5-7 years. Prosthetic joint infection, peri-prosthetic fracture and extensor mechanism complications were the commonest mode of failure. The P value was found to be significant when comparing KSS pre-operatively and post-operatively. CONCLUSION The cumulative implant survival rate was found to be 87.8%. Prosthetic joint infection was the commonest mode of failure in patients who underwent third-generation RHK surgery for variable indications. Being a patient with a high Charlson comorbidity index is the main risk factor associated with failure of the rotating hinge implant.
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Affiliation(s)
- Nouman Memon
- Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, National Stadium Rd, Sindh, 74800, Karachi, Pakistan
| | - Faizan Iqbal
- Department of Orthopaedic Surgery, Patel Hospital, ST-18 Block 4 Gulshan-e-Iqbal, Sindh, 75300, Karachi, Pakistan.
| | - Syed Shahid Noor
- Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, National Stadium Rd, Sindh, 74800, Karachi, Pakistan
| | - Kazim Rahim Najjad
- Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, National Stadium Rd, Sindh, 74800, Karachi, Pakistan
| | - Muhammad Farhan Sozera
- Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, National Stadium Rd, Sindh, 74800, Karachi, Pakistan
| | - Arsalan Abro
- Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, National Stadium Rd, Sindh, 74800, Karachi, Pakistan
| | - Noman Khan
- Department of Orthopaedic Surgery, Liaquat National Hospital and Medical College, National Stadium Rd, Sindh, 74800, Karachi, Pakistan
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Zhang J, Ye P, Zhang L, Wu H, Chi T, Chang Z. Loading comparison of two structures in the moving tube of a non-invasive prosthesis. Technol Health Care 2021; 29:1001-1009. [PMID: 33492253 DOI: 10.3233/thc-202420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The treatment of adolescent patients with distal femoral cancer has always been a concern. The limb-salvage, regarded as a mainstream treatment, had been developed in recent years, but its application in children still remains challenging. This is because it can lead to potential limb-length discrepancy from the continued normal growth of the contralateral lower body. The extendable prosthesis could solve this problem. The principle is that it can artificially control the length of the prosthesis, making it consistent with the length of the side of the lower limbs. However, this prosthesis has some complications. The extendable prosthesis is classified into invasive and minimally invasive, which extends the prosthesis with each operation. OBJECTIVE We designed a new non-invasive prosthesis that can be extended in the body. Based on the non-invasive and extendable characteristics, we need to verify the supporting performance of this prosthesis. METHODS We carried out a mechanical testing method and finite element analysis simulation. CONCLUSION The support performance and non-invasively extension of this prosthesis were verified.
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Affiliation(s)
- Jie Zhang
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Ping Ye
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Lizheng Zhang
- Department of R&D of Special Equipment and Product, Institute of Microport Engineering, Shanghai MicroPort Medical (Group) Co., Ltd. Shanghai, China
| | - Hongliu Wu
- Department of R&D of Special Equipment and Product, Institute of Microport Engineering, Shanghai MicroPort Medical (Group) Co., Ltd. Shanghai, China
| | - Tianxi Chi
- Department of R&D of Special Equipment and Product, Institute of Microport Engineering, Shanghai MicroPort Medical (Group) Co., Ltd. Shanghai, China
| | - Zhaohua Chang
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Department of R&D of Special Equipment and Product, Institute of Microport Engineering, Shanghai MicroPort Medical (Group) Co., Ltd. Shanghai, China
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9
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Zhang J, Chang Z, Zhang L, Ye P, Chi T. Noninvasive extendable prosthesis: a new design. BIOTECHNOL BIOTEC EQ 2020. [DOI: 10.1080/13102818.2020.1774416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Jie Zhang
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Zhaohua Chang
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, PR China
- Department of R&D of Special Equipment and Product, Institute of Microport Engineering, Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, PR China
| | - Lizheng Zhang
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Ping Ye
- Shanghai Institute for Minimally Invasive Therapy, School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, PR China
| | - Tianxi Chi
- Department of R&D of Special Equipment and Product, Institute of Microport Engineering, Shanghai MicroPort Medical (Group) Co., Ltd, Shanghai, PR China
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