Cause of infection in proximal tibial endoprosthetic reconstructions

Cho, Wan; Song, Won; Jeon, Dae-Geun; Kong, Chang-Bae; Kim, Jung; Lee, Soo-Yong
February 2012
Archives of Orthopaedic & Trauma Surgery;Feb2012, Vol. 132 Issue 2, p163
Academic Journal
Introduction: The underlying cause of proximal tibial prosthetic failure by infection is unclear. We asked: (1) Is resection amount related to prosthetic infection? (2) What other risk factors are related with infection? (3) What are the survivorship and functional outcomes of proximal tibial endoprosthetic reconstruction? Methods: Sixty-two patients who underwent modular proximal tibial megaprosthesis reconstruction were analyzed. Follow-up duration averaged 98 months (range 26-240 months). Associations between prognostic variables and prosthesis survival were assessed. Results: The 10-year prosthetic survival of the 62 implants was 73.9 ± 11.7%. Prostheses were removed in 16 (25.8%) patients for infection and 3 of the 16 underwent amputation. Resection of >37% ( P = 0.016) of the tibia was found to be related to infection. Application of chemotherapy ( P = 0.912) and use of synthetic material to fix the patella tendon ( P = 0.2) were not found to influence prosthetic survival. Functional outcomes (determined by the MSTS system) of the 52 patients that maintained a mobile joint averaged 24.2 (81%) (range 18-28). Conclusions: Our study suggests that the amount of bone resection is related with prosthetic failure by infection, however, the contribution of other risk factors should not be underestimated.


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