Endoprosthetic reconstruction of the distal tibia and ankle joint after resection of primary bone tumours

• Published in: Journal of bone and joint surgery. British volume Vol. 91; no. 10; pp. 1378 - 1382
• Main Authors: SHEKKERIS, A. S, HANNA, S. A, SEWELL, M. D, SPIEGELBERG, B. G. I, ASTON, W. J. S, BLUNN, G. W, CANNON, S. R, BRIGGS, T. W. R
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.10.2009
• Subjects: Adolescent; Adult; Aged; Amputation; Ankle Joint - diagnostic imaging; Ankle Joint - physiopathology; Ankle Joint - surgery; Arthroplasty, Replacement - methods; Biological and medical sciences; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - physiopathology; Bone Neoplasms - surgery; Diseases of the osteoarticular system; Female; Humans; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteosarcoma - diagnostic imaging; Osteosarcoma - physiopathology; Osteosarcoma - surgery; Prosthesis Design; Radiography; Range of Motion, Articular; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tibia - diagnostic imaging; Tibia - physiopathology; Tibia - surgery; Treatment Outcome; Tumors of striated muscle and skeleton; Young Adult; Ankle joint; Orthopedic surgery; Treatment; Tibia; Bone tumor; Diseases of the osteoarticular system; Surgical resection; Anatomical reconstruction
• ISSN: 0301-620X; 2044-5377
• DOI: 10.1302/0301-620X.91B10.22643

Endoprosthetic replacement of the distal tibia and ankle joint for a primary bone tumour is a rarely attempted and technically challenging procedure. We report the outcome of six patients treated between 1981 and 2007. There were four males and two females, with a mean age of 43.5 years (15 to 75), and a mean follow-up of 9.6 years (1 to 27). No patient developed a local recurrence or metastasis. Two of the six went on to have a below-knee amputation for persistent infection after a mean 16 months (1 to 31). The four patients who retained their endoprosthesis had a mean musculoskeletal tumour society score of 70% and a mean Toronto extremity salvage score of 71%. All were pain free and able to perform most activities of daily living in comfort. A custom-made endoprosthetic replacement of the distal tibia and ankle joint is a viable treatment option for carefully selected patients with a primary bone tumour. Patients should, however, be informed of the risk of infection and the potential need for amputation if this cannot be controlled.