Results of arthroplasty in oncological patients with primary and metastatic bone tumours around the knee

Derzhavin V.A., Buharov A.V., Yadrina A.V., Erin D.A.

Abstract


Relevance
Knee joint replacement is the main method of surgical treatment in patients with oncological lesions of the distal femur and proximal tibia. The article presents the results of the use of this technique in Herzen Moscow Research Institute for Oncology.
Purpose
To evaluate the results of arthroplasty in patients with tumour lesions of the distal femur and proximal tibia.
Materials and methods
Between 2011 and 2019, primary knee replacement due to oncology was performed in 106 patients. Distal femoral resection was performed in 70 (66%), proximal tibia resection in 36 (34%) patients. Primary bone tumors were detected in 70 (66%) patients. Metastases of various solid tumors were observed in 36 (34%) patients.
Results
In the group of patients with primary malignant bone tumours (49 patients), 36 (73.5%) patients survived without signs of tumour progression, 3 (6%) were alive with disease manifestations, 10 (20.5%) patients died from progression. Relapse was diagnosed in 6 (12%), metastatic lung damage in 13 (26%). All patients with a giant cell tumour survived without signs of disease progression. In the group of patients with metastatic lesions (36 patients), 25 patients (69%) died from disease progression. The average value of the functional result on the MSTS scale was 78% for all endoprostheses. The incidence of postoperative complications was 30%, among which the prevailing was infection (9.5%).
Conclusion
The main adverse event in arthroplasty of large joints in oncologic patients remains the frequency of postoperative complications, which can develop in 20 to 30% of the patients. Further research on the possibility of using various designs and types of implants is necessary in order to reduce the incidence of postoperative complications and improve long-term functional outcomes in such patients.

Keywords


bone tumors, surgical treatment, joint arthroplasty

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DOI: http://dx.doi.org/10.18019/1028-4427-2020-26-3-347-352

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