Results of 20 consecutive patients treated with the Repiphysis expandable prosthesis for primary malignant bone

  title={Results of 20 consecutive patients treated with the Repiphysis expandable prosthesis for primary malignant bone},
  author={Joseph Benevenia and Francis R. Patterson and Kathleen S Beebe and Kimberly K. Tucker and Jeffrey Moore and Joseph A. Ippolito and Steven M. Rivero},
Limb-salvage for primary malignant bone tumors in pediatric patients presents a unique challenge when resection includes an active physis. Early expandable prostheses required open surgical procedures to achieve lengthening. Newer prostheses are capable of achieving expansion without open procedures through the use of an electromagnetic field. This study reports our results with 90 consecutive expansion procedures using the Repiphysis® prosthesis. We retrospectively reviewed the records of 20… 

Long-term follow-up of children treated with the Repiphysis expandable prosthesis for lower extremity bone sarcoma

Despite being an option for limb salvage, the Repiphysis prosthesis has a high rate of mechanical failure and need for revision, similar to other expandable implants, and the authors recommend full disclosure of the potential short- and long-term complications.

Free Vascularized Fibula Salvage of Failed CPH in Pediatric Sarcoma Patients

A free VFF is a viable option for upper extremity salvage after previously failed reconstructions because it provides vascularized tissue to a scarred tissue bed and allows for the replacement or augmentation of large bony defects.

The role of expandable prostheses

In skeletally immature individuals who require wide tumor resection with removal of an active physis, an expandable prosthesis can be used for limb salvage and their longevity is still a concern.

Long-term outcomes of non-invasive expandable endoprostheses for primary malignant tumors around the knee in skeletally-immature patients

With improvements made in the last generation of “non-invasive” prostheses, implants’ survival has been substantially lengthened and Chemotherapy and limb-salvage surgery yield good oncologic outcomes.

Outcomes of Expandable Prostheses for Primary Bone Malignancies in Skeletally Immature Patients: A Systematic Review and Pooled Data Analysis.

A systematic review of peer-reviewed published literature from 1997 to 2017 provides clinicians with pooled summary data representing the largest summary of outcomes after reconstruction with expandable prostheses to date, and can assist surgeons to better understand and educate their patients and their families on functional outcomes.

Endoprosthetic Reconstruction in Ewing’s Sarcoma Patients: A Systematic Review of Postoperative Complications and Functional Outcomes

This is the first comprehensive review to evaluate the outcomes of limb salvage surgery with endoprostheses exclusively in Ewing’s sarcoma patients and there was a suggestion of ‘good’ functional outcomes with limb salvage operations.

[Application of proximal tibial hemiprosthesis replacement and second-stage revision for proximal tibial osteosarcoma in three children].

The proximal tibial hemiprosthesis replacement in the first stage combined with prosthesis revision in the second stage for treating the proximalTibial tibia osteosarcoma in children can keep the distal femur growth ability, reduce the length discreapancy of lower limb, and obtain satisfactory stability and good function.

Causes and Frequencies of Reoperations After Endoprosthetic Reconstructions for Extremity Tumor Surgery: A Systematic Review

The aggregated data are the first to attempt to quantify the time to specific complication types within this patient population, and the quality of published evidence regarding this procedure is of low quality with high loss to followup and data quality limiting interstudy analysis.

Vascularized Fibula Epiphysis Transfer for Pediatric Extremity Reconstruction: A Systematic Review and Meta-analysis

Vascularized fibula epiphysis transfer can accomplish full long-term growth and function, however, complications, revision surgery, and chronic impairment are common.

Functional and Surgical Outcomes After Endoprosthetic Reconstruction With Expandable Prostheses in Children: A Systematic Review.

A systematic review of the literature was performed to identify studies focusing on the functional and surgical outcomes of the application of expandable endoprostheses.



Frequent Complications and Severe Bone Loss Associated With the Repiphysis Expandable Distal Femoral Prosthesis

Bone loss around the stem of this prosthesis limits subsequent revision options, often resulting in a total femoral prosthesis, and most patients will not have sufficient bone stock to permit future revision using standard stem fixation.

Evaluation of a noninvasive expandable prosthesis in musculoskeletal oncology patients for the upper and lower limb.

The Repiphysis noninvasive prosthesis provides acceptable functional outcomes for both upper and lower extremity implantation and appears to have an advantage as compared to conventional expandable prosthetics, which require open procedures that can potentially increase the risk of infection from repeated hardware exposure.

Non-invasive distal femoral expandable endoprosthesis for limb-salvage surgery in paediatric tumours.

The implant avoids multiple surgical procedures, general anaesthesia and assists in maintaining leg-length equality and complications developed in two patients; one developed a flexion deformity at the knee joint, which was subsequently overcome and one died of disseminated disease.

Early Multicenter Experience With a Noninvasive Expandable Prosthesis

It is optimistic that this technology will prove beneficial, not only for patients with malignant bone tumors but in applications requiring serial limb length equalizations or for spinal deformities.

Early results of a non-invasive extendible prosthesis for limb-salvage surgery in children with bone tumours.

Early results demonstrate that the non-invasive extendible prosthesis allows successful lengthening without surgical intervention, but the high incidence of infection is a cause for concern.

Modular endoprostheses for children with malignant bone tumors.

Limb-preserving surgery in children with malignant bone tumors can be accomplished successfully with modern prosthetic devices that have expandable modules within them, and the technique of expandable prostheses using electromagnetic fields rather than surgical interventions shows promise.

Outcome of lower-limb preservation with an expandable endoprosthesis after bone tumor resection in children.

Current technology does not offer a single best reconstruction option for children with malignant pediatric lower-extremity bone tumors and the literature supports no single superior treatment among these three options with regard to physical or emotional health.

Expandable Endoprosthesis Reconstruction in Skeletally Immature Patients With Tumors

Children's functional results were similar to the results reported for adults with an average Musculoskeletal Tumor Society rating of good to excellent at the knee, fair to good at the hip, and fair about the shoulder.

Extendable tumour endoprostheses for the leg in children.

Implantation of extendable endoprostheses in children provides a reasonable alternative to rotationplasty, but limb salvage requires more operations.

The medium-term results of the Stanmore non-invasive extendible endoprosthesis in the treatment of paediatric bone tumours.

This is the largest reported series using non-invasive extendible endoprosthesis after excision of primary bone tumours in skeletally immature patients and produces a good functional outcome, with prevention of limb-length discrepancy at skeletal maturity.