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

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Abstract

[Indexed for MEDLINE] 18. Eur J Orthop Surg Traumatol. 2017 Aug;27(6):737-746. doi: 10.1007/s00590-017-1985-x. Epub 2017 Jun 5. Intercalary reconstructions after bone tumor resections: a review of treatments. Panagopoulos GN(1), Mavrogenis AF(2), Mauffrey C(3), Lesenský J(4), Angelini A(5), Megaloikonomos PD(1), Igoumenou VG(1), Papanastassiou J(6), Savvidou O(1), Ruggieri P(5), Papagelopoulos PJ(1). Author information: (1)First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Street, Holargos, 15562, Athens, Greece. (2)First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Street, Holargos, 15562, Athens, Greece. afm@otenet.gr. (3)Department of Orthopaedics, Denver Health Medical Center, Denver, CO, USA. (4)Department of Orthopaedics, First Medical Faculty, Prague Teaching Hospital, Charles University, Bulovka, Prague, Czechia. (5)Department of Orthopaedics and Musculoskeletal Oncology, University of Padova, Padova, Italy. (6)Department of Orthopaedics, Agioi Anargyroi Hospital, Athens, Greece. An intercalary reconstruction is defined as replacement of the diaphyseal portion of a long bone after segmental skeletal resection (diaphysectomy). Intercalary reconstructions typically result in superior function compared to other limb-sparing procedures as the patient's native joints above and below the reconstruction are left undisturbed. The most popular reconstructive options after segmental resection of a bone sarcoma include allografts, vascularized fibula graft, combined allograft and vascularized fibula, segmental endoprostheses, extracorporeal devitalized autograft, and segmental transport using the principles of distraction osteogenesis. This article aims to review the indications, techniques, limitations, pros and cons, and complications of the aforementioned methods of intercalary bone tumor resections and reconstructions in the context of the ever-growing, brave new field of limb-salvage surgery. DOI: 10.1007/s00590-017-1985-x