4.P.12 ENDOPROSTHETIC REPLACEMENT IN CHILDREN AND ADOLESCENTS WITH LONG BONE SARCOMAS: EXPERIENCE FROM ONE INSTITUTION

Abstract

Purpose: Function of the extremity assessment in children and adolescents treated with endoprostheses for bone sarcomas.

Method: We studied the results of the endoprosthetic replacements in 26 patients 5–17 years old (med-12,8) with malignant primary tumors: osteosarcoma (20), Ewing sarcoma (2), chondrosarcoma (3), rhabdomyosarcoma with bone affection (1). The surgeries were provided in 2004–2008 years for the joints: knee (19 – femur (10), tibia (9)), coxofemoral (2), humeral (4), elbow (1). We used non-expandable endoprostheses in 10 patients 13–17 years (med -15,3) and expandable ones in 16 patients 5–15 years (med-1,1): PROSPON (10), MUTARS (14) and REPIPHYSIS (2). Invasive lengthening was held for PROSPON (8 procedures in 5 patients) and noninvasisve for MUTARS and REPIPHYSIS (8 patients). All the patients underwent protocol therapy. The term of observation was 0,5–4,5 years (med-2,1). For low extremity good function was assessed as the ability of walking with ease, equal length of two legs and sufficient artificial joint’s mobility. For upper extremity good function was assessed as the ability of using an arm freely in daily life (including writing and typing), equal length of two arms and sufficient artificial joint’s mobility.

Results: 18 patients (69,2%) are alive. Local relapse had place in 1 (3,9%) case. Good function of an extremity was registered in 14 (73,7%) patients who survived. The best results we saw in noninvasive maintaining equal limb length.

Conclusion: Endoprosthetic replacement in a complex with protocol therapy secures good function of an extremity in children and adolescents with malignant primary bone sarcomas.