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Advances in Orthopedics
Volume 2013, Article ID 397456, 5 pages
http://dx.doi.org/10.1155/2013/397456
Clinical Study

Distal Femur Allograft Prosthetic Composite Reconstruction for Short Proximal Femur Segments following Tumor Resection

1MD Anderson Cancer Center, Department of Orthopaedic Oncology, P.O. Box 301402, Houston, TX 77230-1402, USA
2Greater Dallas Orthopaedics, 12230 Coit Road, Suite 100, Dallas, TX 75251, USA
3Polyclinic Department of Orthopaedic Surgery, 1001 Broadway, Suite 109, Seattle, WA 98122, USA

Received 5 June 2013; Accepted 2 October 2013

Academic Editor: Allen L. Carl

Copyright © 2013 Bryan S. Moon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Short metaphyseal segments remaining after distal femoral tumor resection pose a unique challenge. Limb sparing options include a short stemmed modular prosthesis, total endoprosthetic replacement, cross-pin fixation to a custom implant, and allograft prosthetic composite reconstruction (APC). A series of patients with APC reconstruction were evaluated to determine functional and radiologic outcome and complication rates. Twelve patients were retrospectively identified who had a distal femoral APC reconstruction between 1994 and 2007 to salvage an extremity with a segment of remaining bone that was less than 20 centimeters in length. Seventeen APC reconstructions were performed in twelve patients. Eight were primary procedures and nine were revision procedures. Average f/u was 89 months. Twelve APC reconstructions (71%) united and five (29%) were persistent nonunions. At most recent followup 10 patients (83%) had a healed APC which allowed WBAT. One pt (8%) had an amputation and one pt (8%) died prior to union. Average time to union was 19 months. Four pts (33%) or five APC reconstructions (29%) required further surgery to obtain a united reconstruction. Although Distal Femoral APC reconstruction has a high complication rate, a stable reconstruction was obtained in 83% of patients.