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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_19 | Pages 57 - 57
1 Dec 2014
Olivier A Ghani Y Konan S Khan S Briggs TWR Skinner J Pollock R Aston W
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Introduction:. Non-invasive extendible endoprostheses (NIEE) were primarily developed for salvage after musculo-skeletal tumour surgery in the immature skeleton. However, they may also have a unique application to manage complex limb reconstruction in revision surgery to address limb-length inequality in the mature skeleton. The aim of this study is to present the minimum 2 –year results of using non-invasive extendible endoprostheses for complex lower limb reconstruction. Methods:. Between 2004 and 2013, 21 patients were treated with 23 NIEE. The indication for surgery was salvage of infected prosthesis following primary tumor resection in 6 cases, aseptic prosthesis failure after primary tumour resection in 5 cases, aseptic non-tumor prosthesis failure in 1 case, infected non-tumor prosthesis in 8 cases and symptomatic non-union of graft reconstruction in 3 cases. There were 14 male and 7 female patients with a mean age of 49.8 years (range 19–81). Results:. The mean length gained was 41.5 mm (range 0 to 90) requiring a mean of 7 (0–25) lengthening episodes performed in the outpatient department. 4 cases required revision surgery for persistent infection. These had multiple previous surgeries and inadequate soft tissue coverage. There were also 2 early dislocations in one patient treated successfully with lengthening and 1 failure to achieve desired length. The Mean Musculoskeletal Tumour Society rating score was 19. Conclusion:. The use of NIEE is associated with good functional outcome and offers yet another way of limb salvage. A modest complication rate is noted in this series, which reflects the complexity of these cases