Seven-year experience of using Repiphysis expandable prosthesis in children with bone tumors

Pediatr Blood Cancer. 2010 Sep;55(3):457-63. doi: 10.1002/pbc.22598.

Abstract

Background: Results of the use of the non-invasive expandable endoprosthetic device Repiphysis in limb salvage surgery for skeletally immature children with bone cancer have been promising.

Procedure: In this report, we analyze the outcomes and complications associated with using 17 Repiphysis prosthesis from January 2002 to March 2009 in 17 skeletally immature children with bone sarcoma around the knee.

Results: The average follow-up was 61.7 months. All patients who underwent active expansion experienced successful lengthening with a total of 38 lengthening sessions and an average of 8.6 mm gained per session. The Musculoskeletal Tumor Society functional scores averaged 90% at the most recent follow-up. The average survival time of the device from implementation to revision or last follow-up was 2 years and 8 months. There were 12 complications in 12 patients, including 6 mechanical problems, 2 tibial fractures and 3 infections. For the 17 insertions, 7 revision operations were performed, 3 of which were done using a new Repiphysis device.

Conclusions: Despite the high rate of complications, the goal of achieving equal leg length at skeletal maturity with fewer surgeries per patient has been relatively achieved with the use of this device.

MeSH terms

  • Adolescent
  • Bone Neoplasms / surgery*
  • Child
  • Female
  • Femoral Neoplasms / surgery*
  • Humans
  • Leg Length Inequality / prevention & control
  • Limb Salvage*
  • Male
  • Osteosarcoma / surgery*
  • Prostheses and Implants* / adverse effects
  • Prosthesis Failure
  • Prosthesis Implantation / adverse effects
  • Reoperation
  • Tibia* / surgery