From amputation to limb salvage reconstruction: evolution and role of the endoprosthesis in musculoskeletal oncology.

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Abstract

[Indexed for MEDLINE] 19. Orthopade. 2019 Jul;48(7):598-604. doi: 10.1007/s00132-019-03720-x. [Silver coating on tumour prostheses]. [Article in German] Friesenbichler J(1), Bergovec M(2), Maurer-Ertl W(2), Reinbacher P(2), Maier M(2), Amerstorfer F(2), Leithner A(2). Author information: (1)Univ. Klinik für Orthopädie und Traumatologie, Medizinische Universität Graz, Auenbruggerplatz 5, 8036, Graz, Österreich. joerg.friesenbichler@medunigraz.at. (2)Univ. Klinik für Orthopädie und Traumatologie, Medizinische Universität Graz, Auenbruggerplatz 5, 8036, Graz, Österreich. Erratum in Orthopade. 2019 Dec;48(12):1057. doi: 10.1007/s00132-019-03835-1. BACKGROUND: Modular endoprostheses, so-called "tumour or megaprostheses" are mainly used for limb salvage surgery after resection of malignant soft tissue or a bone tumour. Sometimes, this type of prosthesis is also used for revision surgeries after failed primary joint arthroplasty. Despite continuously improving techniques and quality management systems, periprosthetic infection is one of the most serious complications. AIM OF THE STUDY: Review of the literature in the PubMed data base with the main focus on silver coatings in joint arthroplasty and their effect on infection rate, outcome and patients' safety. RESULTS: The current literature shows that there is a beneficial role of silver coatings in megaprostheses in terms of revision rates for septic complications, especially following tumour resection with bad soft tissue coverage or in (multimorbid) high-risk patients, compared to uncoated implants. DISCUSSION: Based on the results of previous publications examining blood or serum silver concentrations or silver levels in urine, silver coatings do not appear to have side effects, except for local argyria. Continuous monitoring of silver levels in blood or serum is still recommended, and additional long-term studies will be necessary to verify the effectiveness and safety of silver coatings. DOI: 10.1007/s00132-019-03720-x