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Publication Detail
The medium-term results of the Stanmore non-invasive extendible endoprosthesis in the treatment of paediatric bone tumours.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Evaluation Studies
  • Authors:
    Picardo NE, Blunn GW, Shekkeris AS, Meswania J, Aston WJ, Pollock RC, Skinner JA, Cannon SR, Briggs TW
  • Publication date:
    03/2012
  • Pagination:
    425, 430
  • Journal:
    J Bone Joint Surg Br
  • Volume:
    94
  • Issue:
    3
  • Country:
    England
  • Print ISSN:
    0301-620X
  • PII:
    94-B/3/425
  • Language:
    eng
  • Keywords:
    Adolescent, Bone Lengthening, Bone Neoplasms, Child, Child, Preschool, Female, Femur, Follow-Up Studies, Growth, Humans, Knee Joint, Leg Length Inequality, Limb Salvage, Lower Extremity, Male, Prostheses and Implants, Prosthesis Design, Prosthesis Implantation, Range of Motion, Articular, Reoperation, Tibia, Treatment Outcome
Abstract
In skeletally immature patients, resection of bone tumours and reconstruction of the lower limb often results in leg-length discrepancy. The Stanmore non-invasive extendible endoprosthesis, which uses electromagnetic induction, allows post-operative lengthening without anaesthesia. Between 2002 and 2009, 55 children with a mean age of 11.4 years (5 to 16) underwent reconstruction with this prosthesis; ten patients (18.2%) died of disseminated disease and one child underwent amputation due to infection. We reviewed 44 patients after a mean follow-up of 41.2 months (22 to 104). The mean Musculoskeletal Tumor Society score was 24.7 (8 to 30) and the Toronto Extremity Salvage score was 92.3% (55.2% to 99.0%). There was no local recurrence of tumour. Complications developed in 16 patients (29.1%) and ten (18.2%) underwent revision. The mean length gained per patient was 38.6 mm (3.5 to 161.5), requiring a mean of 11.3 extensions (1 to 40), and ten component exchanges were performed in nine patients (16.4%) after attaining the maximum lengthening capacity of the implant. There were 11 patients (20%) who were skeletally mature at follow-up, ten of whom had equal leg lengths and nine had a full range of movement of the hip and knee. This is the largest reported series using non-invasive extendible endoprostheses after excision of primary bone tumours in skeletally immature patients. The technique produces a good functional outcome, with prevention of limb-length discrepancy at skeletal maturity.
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