A systematic review of endoprosthetic replacement for non-tumour indications around the knee joint

作者：Korim Muhammad T^*; Esler Colin N A; Reddy Venuthurla R M; Ashford Robert U

来源：Knee, 2013, 20(6): 367-375.

DOI：10.1016/j.knee.2013.09.001

• Knee
• Endoprosthetic replacement
• Tumour
• Survivorship
• Massive bone loss
• Fractures

Background: Endoprosthetic replacement (EPR) for limb salvage is an established treatment modality for orthopaedic malignancies around the knee. Increasingly, they are being used for non-tumour indications such as fractures, bone loss associated with aseptic loosening, septic loosening and ligament insufficiencies. %26lt;br%26gt;Methods: We reviewed the evolution and biomechanics of knee EPRs. MEDLINE was searched using the PubMed interface to identify relevant studies pertaining to the use of knee EPRs in non-tumour conditions. Failures, mortality and knee scores were the main outcome measures. Subgroup analysis in the non-tumour conditions was also performed. %26lt;br%26gt;Results: There were nine studies with an average follow-up of 3.3 years (Range 1-5 years) describing 241 EPRs used in non-tumour conditions. Re-operation for any reason occurred in 17% (41/241) of cases. The most common complication was infection (15%) followed by aseptic loosening (5%) and periprosthetic fractures (5%). The mortality rate averaged 22%. Infected knee arthroplasties were less likely to have a successful outcome when salvaged with an EPR with failure rates up to 33%. %26lt;br%26gt;Conclusions: Endoprosthetic replacement is a limb salvage option when other surgical options are unfeasible, especially in low demand elderly patients with limited life expectancy. They have low rates of failure in the medium term.

• 出版日期2013-12