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KMID : 0613320020080010001
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Journal of the Korean Bone and Joint Tumor Soceity
2002 Volume.8 No. 1 p.1 ~ p.11
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Evaluation of Prosthetic Reconstruction in Lower Extremity
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Lee Sang-Hoon
Oh Joo-Han
Yoo Kwang-Hyun
Suh Sung-Wook
Koo Ki-Hyoung
Kim Han-Soo
Lim Soo-Taek
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Abstract
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Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity.
Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ≥20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis.
Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure.
Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.
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KEYWORD
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Lower extremity, Bone tumor, Prosthetic reconstruction, Functional and radiologic evaluation
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