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KMID : 0613320010070030088
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Journal of the Korean Bone and Joint Tumor Soceity
2001 Volume.7 No. 3 p.88 ~ p.95
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Functional and Radiological Results of Intermediate-term Follow Up in Distal Femoral Tumor Prosthesis
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Moon Sang-Ho
Lee Sang-Hoon
Oh Joo-Han
Lee Jae-Hag
Hwang Chung-Soo
Lee Han-Koo
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Abstract
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Purpose: To verify intermediate-term functional and radiological changes of limb salvage operation using tumor prosthesis in distal femur.
Materials and Methods: Forty-four cases which used tumor prothesis were reviewed. They have been followed up for average 54.3 months. We retrospectively reviewed complications and survival analysis, and evaluated functionally and radiologically by range of motion, Enneking functional score, ISOLS radiological implants evaluation system and patient & prosthetic survival rate at last follow-up. Data were stastically analyzed according to sex, age, diagnosis, using cement, amount of femoral resection, implant design, local recurrence, metastasis, pre-& post-operative chemotherapy and chemotherapeutic response.
Results: 7 patients had died of disease and local recurrence was seen in 7. Complication was developed in 20 patients. Mean femoral resection was 42.2% and mean range of knee motion was 84.1°. The 3-, 5- and 10-year Kaplan-Meier patient survival rate were 84%, 77%, 64%, respectively and prosthetic survival were 86%, 75%, 60%. Mean value of total functional score was 20.7. Older than 20-year group was superior in remodelling of radiologic assessment(p=0.003) nd patient survival rate(p=0.042). Cement fixation group was superior in remodelling. No recurrence group has higher score n emotional acceptance, walking ability, gait of functional items(p=0.014, 0.033, 0.038) and total score was higher(p=0.029).
No pre- & post-operative chemotherapeutic group was superior in support(p=0.01). Metastatic group has poorer result in patient survival rate(p=0.01). There were no significant differences in any other comparisons.
Conclusion: In the intermediate term follow-up of distal femoral prosthesis, 5-year patient & prosthetic survival rate were 77%, 75% and complications developed in 45.5%. Functionally, no recurrence and no chemotherapeutic group were better and radiologically, older than 20-year and cement group were better in remodelling.
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KEYWORD
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Distal femur, bone tumor, tumor prosthesis, intermediate-term follow up
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