The cost-effectiveness of limb salvage for bone tumours.

@article{Grimer1997TheCO,
  title={The cost-effectiveness of limb salvage for bone tumours.},
  author={Robert J Grimer and Simon R. Carter and Paul Pynsent},
  journal={The Journal of bone and joint surgery. British volume},
  year={1997},
  volume={79 4},
  pages={
          558-61
        }
}
The use of endoprostheses for limb salvage in primary bone tumours is highly specialised. Studies have shown no significant difference in survival, function or quality of life between patients with limb salvage and those with amputation. We have derived a formula for calculating the ongoing costs of limb salvage with an endoprosthesis which is based on actual costs and uses historical data to show the likelihood of further surgery or revision. Comparative data for amputation are also shown… 
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Recent innovations in modern endoprosthetic design are reviewed, with a focus on outcomes and treatment of surgical complications such as infection, aseptic loosening and extensor mechanism failure.

Risk of amputation following limb salvage surgery with endoprosthetic replacement, in a consecutive series of 1261 patients

The risk of amputation decreased with time, although 10% took place after more than 5 years, and the risque d'amputation diminue avec le temps, bien that 10% des amputations aient eu lieu après plus of 5 years.

Surgery for bone sarcomas of the lower extremity

Surgery for lower extremity bone sarcomas encompasses a wide array of surgical options beyond the classic treatment of amputation, and advances in surgical navigation, expandable endoprostheses, and in treating infected allografts and endop Frostheses are summarized.

Distal Femoral Resection with Endoprosthetic Reconstruction

Use of the modular segmental replacement system (MRS) can provide limb salvage in many patients with osteosarcoma and has an excellent long-term survival rate, is reliable, and presents minimal problems of breakage or dysfunction.

Functional and oncologic outcome of cemented endoprosthesis for malignant proximal femoral tumors

A series of endoprosthetic replacements of the proximal femur for a malignant process is examined to examine a series of benign and malignant conditions.

Endoprosthetic replacement of the proximal tibia.

It is found that the probability of further surgical procedures being required was 70% at ten years and the risk of amputation, 25%.

How much is a leg worth following radical tumor resection in bone sarcomas? Literature review.

Endoprosthetic reconstruction for the treatment of musculoskeletal tumors of the appendicular skeleton and pelvis.

Investigating the survival of endoprosthetic reconstructions in the medium to long term in order to determine the factors associated with their failure is believed to justify the continued use ofendoprostheses for reconstruction following the excision of a bone tumor.

Extendible replacements of the proximal tibia for bone tumours.

The use of extendible prostheses of the proximal tibia remains an experimental procedure and the technique is now using a simpler, minimally invasive, technique which the authors hope will decrease the incidence of complications.

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.
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References

SHOWING 1-10 OF 23 REFERENCES

Endoprosthetic replacement of the proximal femur and acetabulum. A survival analysis.

The survival of patients with chondrosarcoma and osteoclastoma treated by endoprosthetic replacement compares favourably with survival after amputation or excision of the tumour.

Prosthetic replacement of the distal femur for primary bone tumours.

It is concluded that prosthetic replacement of the distal femur can meet the objectives of limb salvage surgery.

Endoprosthetic replacement of the proximal humerus.

Endoprosthetic replacement of the proximal humerus has been performed in the authors' unit on 25 occasions between 1950 and 1982; of the patients with tumours two died from metastases, and three from unrelated causes; local recurrence necessitated amputation in two patients.

Excision of tumours of humerus and femur, with restoration by internal prostheses.

A personal experience is recounted of operations in cases of tumour involving the humerus or femur with restoration by endoprostheses with development of the prostheses from early beginnings.

Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study.

The outcome of treatment of nonmetastatic high-grade osteosarcoma in the distal part of the femur was studied in 227 patients from twenty-six institutions and no difference was identified between the groups with regard to the patient's acceptance of the postoperative state, the ability to walk, or the amount of pain.

Quality of life in bone tumor patients comparing limb salvage and amputation of the lower extremity

In 33 long‐term survivors of lower extremity bone cancer quality‐of‐life data were studied following limb salvage compared to amputation, and physical complaints were reported more often by limb salvage patients, whereas the amputees showed a trend toward lower self‐esteem and isolation in social life, due to their disability.

The long-term results of Stanmore total knee replacements.

Between 1969 and 1971 20 prototypes of the Stanmore total knee prosthesis were used to replace severely arthritic knees in 18 patients. Seven patients died before the final follow-up and one had to…

Psychological outcome of extremity sarcoma survivors undergoing amputation or limb salvage.

There were no significant differences in measures of psychological outcome for patients with extremity sarcomas who underwent limb salvage procedures compared to those who underwent amputation and a psychological-outcome advantage of limb-salvage surgery compared to amputation has yet to be demonstrated.

Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur.

It appears that, compared with above-the-knee amputation or disarticulation of the hip, the use of a limb-salvage procedure for osteosarcoma of the distal end of the femur did not shorten the disease-free interval or compromise long-term survival.

Function after amputation, arthrodesis, or arthroplasty for tumors about the knee.

The patients who had had a malignant skeletal tumor adjacent to the knee were very active, and they were the least worried about damaging the affected limb, but they had difficulty walking on steep, rough, or slippery surfaces.