Abstract
Introduction and Aims: Limb salvage surgery for the pediatric patient poses unique surgical challenges for the orthopaedic oncologist. In the past, surgeons have advocated amputation or rotationplasty as treatment for the skeletally immature child with a malignant bone tumor that involves a major growth plate and has an expected limb length discrepancy.
Method: The Repiphysis is a non-invasively expandable prosthesis. Applications for the knee joint are approved and other joints are pending. The expansion principle involves energy stored in a spring compressed by a locking system. Lengthenings are achieved via exposure to an electromagnetic field that allows controlled release of the spring and can be done without general anesthesia. Numerous small expansions (5–10mm) keep pace as the child grows. Between 1998–2002, 25 prostheses [knee (19), shoulder (five), hip (one)] were implanted in 21 patients. Most were implanted at the time of tumor resection and nine were revisions from previous reconstruction or fusion.
Results: Ninety lengthenings were performed with all but two on an outpatient basis. An average of 5mm was obtained per lengthening (range 1–35mm). The average follow-up was 25 months (range 12–48 months) and the latest Musculoskeletal Tumor Society functional scores averaged 87%. Eight revisions were required for mechanical problems or stem loosening. There was one amputation caused by post-operative arterial thrombosis.
Conclusion: This unique prosthesis offers many benefits in maintaining limb-length equality in growing patients. We are optimistic that this technology will prove beneficial to patients with malignant bone tumors as well as patients requiring serial limb lengthening or those with spinal deformities.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
