Статті в журналах: "Bone endoprostheses"

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Smolle, Maria A., Dimosthenis Andreou, Per-Ulf Tunn, and Andreas Leithner. "Advances in tumour endoprostheses: a systematic review." EFORT Open Reviews 4, no. 7 (July 2019): 445–59. http://dx.doi.org/10.1302/2058-5241.4.180081.

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Tumour endoprostheses have facilitated limb-salvage procedures in primary bone and soft tissue sarcomas, and are increasingly being used in symptomatic metastases of the long bones. The objective of the present review was to analyse articles published over the last three years on tumour endoprostheses and to summarize current knowledge on this topic. The NCBI PubMed webpage was used to identify original articles published between January 2015 and April 2018 in journals with an impact factor in the top 25.9% of the respective category (orthopaedics, multidisciplinary sciences). The following search-terms were used: tumour endoprosthesis, advances tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND tumour. We identified 347 original articles, of which 53 complied with the abovementioned criteria. Articles were categorized into (1) tumour endoprostheses in the shoulder girdle, (2) tumour endoprostheses in the proximal femur, (3) tumour endoprostheses of the knee region, (4) tumour endoprostheses in the pelvis, (5) (expandable) prostheses in children and (6) long-term results of tumour endoprostheses. The topics of interest covered by the selected studies largely matched with the main research questions stated at a consensus meeting, with survival outcome of orthopaedic implants being the most commonly raised research question. As many studies reported on the risk of deep infections, research in the future should also focus on potential preventive methods in endoprosthetic tumour reconstruction. Cite this article: EFORT Open Rev 2019;4:445-459. DOI: 10.1302/2058-5241.4.180081

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Rogala, Piotr, Ryszard Uklejewski, Mariusz Winiecki, Mikołaj Dąbrowski, Jacek Gołańczyk, and Adam Patalas. "First Biomimetic Fixation for Resurfacing Arthroplasty: Investigation in Swine of a Prototype Partial Knee Endoprosthesis." BioMed Research International 2019 (July 1, 2019): 1–14. http://dx.doi.org/10.1155/2019/6952649.

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Resurfacing hip and knee endoprostheses are generally embedded in shallow, prepared areas in the bone and secured with cement. Massive cement penetration into periarticular bone, although it provides sufficient primary fixation, leads to the progressive weakening of peri-implant bone and results in failures. The aim of this paper was to investigate in an animal model the first biomimetic fixation of components of resurfacing arthroplasty endoprostheses by means of the innovative multispiked connecting scaffold (MSC-Scaffold). The partial resurfacing knee arthroplasty (RKA) endoprosthesis working prototype with the MSC-Scaffold was designed for biomimetic fixation investigations using reverse engineering methods and manufactured by selective laser melting. After Ca-P surface modification of bone contacting surfaces of the MSC-Scaffold, the working prototypes were implanted in 10 swines. Radiological, histopathological, and micro-CT examinations were performed on retrieved bone-implant specimens. Clinical examination confirmed very good stability (4 in 5-point Likert scale) of the operated knee joints. Radiological examinations showed good implant fixation (radiolucency less than 2 mm) without any signs of migration. Spaces between the MSC-Scaffold spikes were penetrated by bone tissue. The histological sections showed newly formed trabecular bone tissue between the spikes, and the trabeculae of periscaffold bone were seen in contact with the spikes. The micro-CT results showed the highest percentage of bone tissue ingrowths into the MSC-Scaffold at a distance of 2.5÷3.0 mm from the spikes bases. The first biomimetic fixation for resurfacing arthroplasty was successfully verified in 10 swines investigations using RKA endoprosthesis working prototypes. The performed research shows that the MSC-Scaffold allows for cementless and biomimetic fixation of resurfacing endoprosthesis components in periarticular cancellous bone.

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Smetanin, S. M., and G. M. Kavalerskiy. "Mathematic Modelling of Stress in Healthy Knee Joint and After Arthroplastywith Different Typesof Endoprostheses." N.N. Priorov Journal of Traumatology and Orthopedics 24, no. 2 (June 15, 2017): 11–16. http://dx.doi.org/10.17816/vto201724211-16.

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Purpose of study. To study stressed-deformed state of the healthy knee joint and after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament by the method of numerical mathematical modelling. Materials and methods. Peculiarities of stress distribution in bones were determined on three mathematical models - healthy knee joint and joint after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament at the set load (80 kg) in straightened leg and either 45° or 90° knee flexion. Results. In healthy knee joint with a straightened leg the stress in the tibia is 2.3 times higher than in the femur. With knee flexion the stress in bone tissue increases and this increase is more intensive in the femur. After arthroplasty using endoprosthesis with substitution of the posterior cruciate ligament the stress in the tibia and femur is higher at all flexion angles as compared to arthroplasty using endoprosthesis with posterior cruciate ligament preservation Conclusion. The obtained data may be used for mathematical substantiation of the advantage of endoprosthesis with preservation of the posterior cruciate ligament and in complex with the data of national and international registers will enable to optimize the treatment tactics in patients to whom knee arthroplasty is indicated.

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Smetanin, S. M., and G. M. Kavalerskiy. "Mathematic Modelling of Stress in Healthy Knee Joint and After Arthroplastywith Different Typesof Endoprostheses." Vestnik travmatologii i ortopedii imeni N.N. Priorova, no. 2 (June 30, 2017): 11–16. http://dx.doi.org/10.32414/0869-8678-2017-2-11-16.

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Purpose of study. To study stressed-deformed state of the healthy knee joint and after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament by the method of numerical mathematical modelling.Materials and methods.Peculiarities of stress distribution in bones were determined on three mathematical models - healthy knee joint and joint after arthroplasty using endoprostheses with either preservation or substitution of the posterior cruciate ligament at the set load (80 kg) in straightened leg and either 45° or 90° knee flexion.Results. In healthy knee joint with a straightened leg the stress in the tibia is 2.3 times higher than in the femur. With knee flexion the stress in bone tissue increases and this increase is more intensive in the femur. After arthroplasty using endoprosthesis with substitution of the posterior cruciate ligament the stress in the tibia and femur is higher at all flexion angles as compared to arthroplasty using endoprosthesis with posterior cruciate ligament preservationConclusion.The obtained data may be used for mathematical substantiation of the advantage of endoprosthesis with preservation of the posterior cruciate ligament and in complex with the data of national and international registers will enable to optimize the treatment tactics in patients to whom knee arthroplasty is indicated.

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Mahdal, Michal, Lukáš Pazourek, Vasileios Apostolopoulos, Dagmar Adámková Krákorová, Iva Staniczková Zambo, and Tomáš Tomáš. "Outcomes of Intercalary Endoprostheses as a Treatment for Metastases in the Femoral and Humeral Diaphysis." Current Oncology 29, no. 5 (May 13, 2022): 3519–30. http://dx.doi.org/10.3390/curroncol29050284.

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Background: The purpose of this study was to evaluate the implant survival, functional score and complications of intercalary endoprostheses implanted for metastatic involvement of the femoral and humeral diaphysis. Methods: The selected group covered patients with bone metastasis who were surgically treated with an intercalary endoprosthesis between 2012 and 2021. The functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system, and complications were evaluated by using the failure classification for prosthetics designed by Henderson. Results: The mean follow-up was 29.8 months. In our group of 25 patients with 27 intercalary endoprostheses (18 femurs, 9 humeri), there were 7 implant-related complications (25.9%), which were more common on the humerus (4 cases, 44.4%) than on the femur (3 cases, 16.7%). Only type II failure—aseptic loosening (5 cases, 18.5%)—and type III failure—structural failure (2 cases, 7.4%)—occurred. There was a significantly higher risk of aseptic loosening of the endoprosthesis in the humerus compared with that in the femur (odds ratio 13.79, 95% confidence interval 1.22–151.05, p = 0.0297). The overall cumulative implant survival was 92% 1 year after surgery and 72% 5 years after surgery. The average MSTS score was 82%. The MSTS score was significantly lower (p = 0.008) in the humerus (75.9%) than in the femur (84.8%). Conclusions: The resection of bone metastases and replacement with intercalary endoprosthesis has excellent immediate functional results with an acceptable level of complications in prognostically favourable patients.

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Le Bras, Linh-Aurore, Anatolie Timercan, Marie Llido, Yvan Petit, Bernard Seguin, Bertrand Lussier, and Vladimir Brailovski. "Personalized endoprostheses for the proximal humerus and scapulohumeral joint in dogs: Biomechanical study of the muscles’ contributions during locomotion." PLOS ONE 17, no. 1 (January 24, 2022): e0262863. http://dx.doi.org/10.1371/journal.pone.0262863.

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Osteosarcoma represents one of the most common bone tumours in dogs. It commonly occurs in the proximal humerus, the most affected anatomic site. Until recently, amputation or limb-sparing surgery leading to an arthrodesis coupled with chemotherapy were the only available treatments, but they often lead to complications, reduced mobility and highly impact dog’s quality of life. Prototypes of both articulated and monobloc (no mobility) patient-specific endoprostheses have been designed to spare the limb afflicted with osteosarcoma of the proximal humerus. This study focuses on the biomechanical effects of endoprostheses and shoulder muscle kinematics. For each of the endoprosthesis designs, a minimal number of muscles needed to ensure stability and a certain degree of joint movement during walking is sought. A quasi-static study based on an optimization method, the minimization of the sum of maximal muscle stresses, was carried out to assess the contribution of each muscle to the shoulder function. The identification of the most important muscles and their impact on the kinematics of the prosthetic joint lead to an improvement of the endoprosthesis design relevance and implantation feasibility.

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Bondarenko, S. Ye, S. A. Denisenko, M. Yu Karpinsky, and O. V. Yaresko. "Investigation of the effect of porous titanium cups on stress distribution in bone tissue (mathematical modeling)." TRAUMA 22, no. 3 (July 19, 2021): 28–37. http://dx.doi.org/10.22141/1608-1706.3.22.2021.236320.

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Introduction. During arthroplasty in patients with altered anatomy and osteoporosis of the acetabulum, stable fixation of the acetabular component of the endoprosthesis is a very difficult task. There are studies on the bone tissue bonding to titanium, tantalum and ceramic coatings of endoprostheses. However, there are insufficient data on the influence of the strength characteristics of modern surfaces of the cups for hip endoprostheses on the distribution of mechanical stresses in the bone tissue around the implanted components. The purpose was to study on a mathematical model the changes in the stress-strain state of the endoprosthesis-bone system as a result of using porous tantalum cup. Materials and methods. A mathematical modeling has been carried out of the stress-strain state of the human hip joint in arthroplasty with porous cup. Du-ring the study, a defect in the acetabular roof filled with a bone implant fixed with two screws was simulated, as well as a defect in the acetabular floor filled with bone “chips”. Endoprosthesis cups were modeled in two versions: from solid titanium with a spray coating of porous titanium, and those entirely made of porous titanium. A distributed load of 540 N was applied to the sacrum. A load was applied between the iliac wing and the greater trochanter of the femur simulating the action of the gluteus medius — 1150 N and the gluteus minimus — 50 N. Results. The use of a cup with a coating of porous titanium in the normal state of the acetabulum leads to the occurrence of maximum stresses (15.9 MPa) in its posterior-upper part. Minimum stresses of 4.6 MPa are observed in the center of the acetabulum. The use of an endoprosthesis with porous titanium cup allows reducing the level of stresses in the bone tissue around the cup. If there is a defect in the acetabular roof, a hip endoprosthesis with porous titanium cup causes less stress than a solid titanium cup with coating of porous titanium. But on the graft, the stress level remains practically unchanged, regardless of the type of cup. The use of porous tantalum cup in the presence of a defect in the acetabular floor causes significantly less stress in the bone tissue around it, compared to an all-metal cup with coating. Conclusions. The cup of the hip endoprosthesis made of porous titanium causes significantly less stress in all control points of the model, compared to a cup made of solid titanium with coating of porous titanium, both with defects in the acetabular roof and floor, and without bone defects.

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Gafton, Georgiy, Yuriy Gudz, Ivan Gafton, Grigoriy Zinovev, Vladislav Semiglazov, and V. Petrov. "EXPERIENCE OF ENDOPROSTHETICS OF PATIENTS WITH PELVIC TUMORS." Problems in oncology 63, no. 2 (February 1, 2017): 309–15. http://dx.doi.org/10.37469/0507-3758-2017-63-2-309-315.

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This study presents an analysis of the effectiveness of organ-preserving surgeries using various endoprostheses in patients with malignant tumors of the pelvic bones. Nine patients (male - 3, female - 7) with malignant tumors of the pelvic bones (chondrosarcoma - 7, osteosarcoma - 1, me-tastases - 2) underwent organ-preserving surgeries with endo-prosthetics of the postresection defect. The average age of the patients was 38 years (15-67 years). During the operation two patients were equipped with individual prostheses of Waldemar Link, one patient - a combined prosthesis with an individual pelvic component (from Biomedical) and a modular femoral component. In 7 patients modular structures of Implant-Сast were used. The pelvic component was cementless, femoral -more often (7 cases) on a cement basis. Patients were assessed by oncological, surgical and functional results. Anatomically-functional status was assessed on the MSTS scale. As a conclusion good functional and oncological results can be obtained even with the resection of three segments of the pelvic bones if the ileal bone volume is sufficient for a good fixation of the endoprosthesis. To achieve the most durable fixation of the femoral component of the endoprosthesis it is better to use bone cement.

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TANZER, MICHAEL, ROBERT TURCOTTE, EDWARD HARVEY, and J. DENNIS BOBYN. "EXTRACORTICAL BONE BRIDGING IN TUMOR ENDOPROSTHESES." Journal of Bone and Joint Surgery-American Volume 85, no. 12 (December 2003): 2365–70. http://dx.doi.org/10.2106/00004623-200312000-00014.

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Mironov, S. P., A. V. Balberkin, D. A. Shavyrin, V. N. Karpov, A. F. Kolondaev, and D. A. Snetkov. "Outcomes of Reconstructive Surgery for Defects of the Articular Ends of Bones Using Home Joint Implants." N.N. Priorov Journal of Traumatology and Orthopedics 22, no. 3 (September 15, 2015): 36–40. http://dx.doi.org/10.17816/vto201522336-40.

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Long-term outcomes of reconstructive operations for substitution of post-resection defects of the articular ends of tubular bones that form the hip, knee and shoulder joints using home endoprosthesis were studied. The study included 344 patients who were treated at CITO department of bone pathology from 2004 to 2014. Substitution of the defect was performed in 236 and 108 cases for the knee, hip joints, respectively. Indications for surgical intervention were: bone tumors; previously performed arthroplasty failure; defects of the articular ends after failed traumatologic and orthopaedic operations; severe forms of knee arthroses. Functional results (MSTS scale), survival of constructions, inflammatory complications were analyzed and comparative evaluation with imported analogues was performed. General functional outcomes and rate of complications correspond to the data on application of new oncologic and modular endoprostheses presented in foreign literature.

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Mironov, S. P., A. V. Balberkin, D. A. Shavyrin, V. N. Karpov, A. F. Kolondaev, and D. A. Snetkov. "Outcomes of Reconstructive Surgery for Defects of the Articular Ends of Bones Using Home Joint Implants." Vestnik travmatologii i ortopedii imeni N.N. Priorova, no. 3 (September 30, 2015): 36–40. http://dx.doi.org/10.32414/0869-8678-2015-3-36-40.

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Long-term outcomes of reconstructive operations for substitution of post-resection defects of the articular ends of tubular bones that form the hip, knee and shoulder joints using home endoprosthesis were studied. The study included 344 patients who were treated at CITO department of bone pathology from 2004 to 2014. Substitution of the defect was performed in 236 and 108 cases for the knee, hip joints, respectively. Indications for surgical intervention were: bone tumors; previously performed arthroplasty failure; defects of the articular ends after failed traumatologic and orthopaedic operations; severe forms of knee arthroses. Functional results (MSTS scale), survival of constructions, inflammatory complications were analyzed and comparative evaluation with imported analogues was performed. General functional outcomes and rate of complications correspond to the data on application of new oncologic and modular endoprostheses presented in foreign literature.

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Tsuda, Y., T. Fujiwara, D. Sree, J. D. Stevenson, S. Evans, and A. Abudu. "Physeal-preserving endoprosthetic replacement with short segment fixation in children with bone sarcomas." Bone & Joint Journal 101-B, no. 9 (September 2019): 1144–50. http://dx.doi.org/10.1302/0301-620x.101b9.bjj-2018-1333.r1.

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Aims The aim of this study was to report the results of custom-made endoprostheses with extracortical plates plus or minus a short, intramedullary stem aimed at preserving the physis after resection of bone sarcomas in children. Patients and Methods Between 2007 and 2017, 18 children aged less than 16 years old who underwent resection of bone sarcomas, leaving ≤ 5 cm of bone from the physis, and reconstruction with a custom-made endoprosthesis were reviewed. Median follow-up was 67 months (interquartile range 45 to 91). The tumours were located in the femur in 11 patients, proximal humerus in six, and proximal tibia in one. Results The five-year overall survival rate was 78%. No patient developed local recurrence. The five-year implant survival rate was 79%. In all, 11 patients (61%) developed a complication. Seven patients (39%) required further surgery to treat the complications. Implant failures occurred in three patients (17%) including one patient with aseptic loosening and two patients with implant or periprosthetic fracture. The preserved physis continued to grow at mean 3.3 cm (0 to 14). The mean Musculoskeletal Society score was 88% (67% to 97%). Conclusion Custom-made endoprostheses that aim to preserve the physis are a safe and effective option for preserving physeal growth, limb length, and joint function with an acceptable rate of complications. Cite this article: Bone Joint J 2019;101-B:1144–1150

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Wei, R., W. Guo, R. Yang, X. Tang, Y. Yang, T. Ji, and H. Liang. "Reconstruction of the pelvic ring after total en bloc sacrectomy using a 3D-printed sacral endoprosthesis with re-establishment of spinopelvic stability." Bone & Joint Journal 101-B, no. 7 (July 2019): 880–88. http://dx.doi.org/10.1302/0301-620x.101b7.bjj-2018-1010.r2.

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Aims The aim of this study was to describe the use of 3D-printed sacral endoprostheses to reconstruct the pelvic ring and re-establish spinopelvic stability after total en bloc sacrectomy (TES) and to review its outcome. Patients and Methods We retrospectively reviewed 32 patients who underwent TES in our hospital between January 2015 and December 2017. We divided the patients into three groups on the basis of the method of reconstruction: an endoprosthesis group (n = 10); a combined reconstruction group (n = 14), who underwent non-endoprosthetic combined reconstruction, including anterior spinal column fixation; and a spinopelvic fixation (SPF) group (n = 8), who underwent only SPF. Spinopelvic stability, implant survival (IS), intraoperative haemorrhage rate, and perioperative complication rate in the endoprosthesis group were documented and compared with those of other two groups. Results The mean overall follow-up was 22.1 months (9 to 44). In the endoprosthesis group, the mean intraoperative hemorrhage was 3530 ml (1600 to 8100). Perioperative complications occurred in two patients; both had problems with wound healing. After a mean follow-up of 17.7 months (12 to 38), 9/10 patients could walk without aids and 8/10 patients were not using analgesics. Imaging evidence of implant failure was found in three patients, all of whom had breakage of screws and/or rods. Only one of these, who had a local recurrence, underwent re-operation, at which solid bone-endoprosthetic osseointegration was found. The mean IS using re-operation as the endpoint was 32.5 months (95% confidence interval 23.2 to 41.8). Compared with the other two groups, the endoprosthesis group had significantly better spinopelvic stability and IS with no greater intraoperative haemorrhage or perioperative complications. Conclusion The use of 3D-printed endoprostheses for reconstruction after TES provides reliable spinopelvic stability and IS by facilitating osseointegration at the bone-implant interfaces, with acceptable levels of haemorrhage and complications. Cite this article: Bone Joint J 2019;101-B:880–888.

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Chernohorskyi, Denis M., Yuriy V. Chepurnyi, Oleksandr A. Kanyura, and Andriy V. Kopchak. "TOTAL MANDIBULAR DEFECT RECONSTRUCTION BY TOTAL TITANIUM PATIENT-SPECIFIC IMPLANT: CLINICAL EFFICACY AND LONG TERM FOLLOW UP. CLINICAL CASE." Wiadomości Lekarskie 74, no. 4 (2021): 1037–41. http://dx.doi.org/10.36740/wlek202104142.

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The aim of this clinical case in demonstrating the possibility of replacing total defect of the mandible with a patient specific implant and the result of long-term follow up. Literature data on the replacement of total mandibular defects are extremely limited and they are presented by only several clinical cases where various surgical approaches were used. In the available literature, there are two approaches to solving this problem, including the replacement of the jaw with vascularised bone grafts, of which the fibula flap is the most promising, and the implantation of endoprostheses of the jaws, of which patient-specific anatomical endoprostheses made using additive technologies are the most advanced. The concept of using patient-specific endoprostheses of the whole mandible is considered revolutionary because it has a number of significant benefits, including the greatest accuracy in restoring the anatomical shape of the mandible. One of the unresolved problems associated with the installation of total mandibular endoprostheses is the prosthetic rehabilitation of patients using fixed structures. The analysis of the presented case can be a good tool for the clinician and bioengineer while making the final decision on the treatment method and modality in patients who need an identical option for the repair of a mandibular defect. Based on CT data, we can conclude that the employed approach, methodology of design and manufacture of patient-specific titanium mandibular endoprosthesis for the total defect demonstrated the sufficient efficacy, which suggest the need for further systematic studies to address this issue.

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Basiaga, Marcin, and Joanna Przondziono. "Biomechanical Analysis of Selected Endoprostheses of Hip Joint by Means of Finite Element Methods." Solid State Phenomena 226 (January 2015): 29–32. http://dx.doi.org/10.4028/www.scientific.net/ssp.226.29.

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The main purpose of this paper was biomechanical analysis of hip joint endoprosthesis – femur systems by means of the Finite Element Method. During the analysis two endoprostheses with differential geometric features were selected. Geometric models of analysed implants were compiled on the grounds of real models like Merotan and The DePuy Proxima which were chosen from series diamensional. Afterwards the models were discretization and boundary conditions were set. Those boundary conditions with right accuracy copied a phenomena which occurred in real models - the Pauwels model. The field of analysis involved determination of the state of displacements, strains and stresses which were cut down in the of endoprosthesis – bone systems. The analysis that was carried out constitute the basics for optimisation of implant geometry and right selection of material’s mechanical properties to its production.

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Tillman, Roger M., Robert J. Grimer, Simon R. Carter, W. Paul Cool, and Rodney S. Sneath. "Growing endoprostheses for primary malignant bone tumors." Seminars in Surgical Oncology 13, no. 1 (January 1997): 41–48. http://dx.doi.org/10.1002/(sici)1098-2388(199701/02)13:1<41::aid-ssu7>3.0.co;2-4.

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Abdikarimov, K. G., M. A. Gafur-Akhunov, U. Islamov, D. Polatova, S. Urunbaev, F. Nasritdinov, and R. Davletov. "498. Endoprostheses in Treatment of Bone Tumors." European Journal of Surgical Oncology 38, no. 9 (September 2012): 874–75. http://dx.doi.org/10.1016/j.ejso.2012.06.442.

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Uklejewski, Ryszard, Mariusz Winiecki, Piotr Rogala, and Adam Patalas. "Structural-Geometric Functionalization of the Additively Manufactured Prototype of Biomimetic Multispiked Connecting Ti-Alloy Scaffold for Entirely Noncemented Resurfacing Arthroplasty Endoprostheses." Applied Bionics and Biomechanics 2017 (2017): 1–14. http://dx.doi.org/10.1155/2017/5638680.

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The multispiked connecting scaffold (MSC-Scaffold) prototype, inspired by the biological system of anchorage of the articular cartilage in the periarticular trabecular bone by means of subchondral bone interdigitations, is the essential innovation in fixation of the bone in resurfacing arthroplasty (RA) endoprostheses. The biomimetic MSC‐Scaffold, due to its complex geometric structure, can be manufactured only using additive technology, for example, selective laser melting (SLM). The major purpose of this work is determination of constructional possibilities for the structural-geometric functionalization of SLM‐manufactured MSC‐Scaffold prototype, compensating the reduced ability—due to the SLM technological limitations—to accommodate the ingrowing bone filling the interspike space of the prototype, which is important for the prototype bioengineering design. Confocal microscopy scanning of components of the SLM‐manufactured prototype of total hip resurfacing arthroplasty (THRA) endoprosthesis with the MSC‐Scaffold was performed. It was followed by the geometric measurements of a variety of specimens designed as the fragments of the MSC-Scaffold of both THRA endoprosthesis components. The reduced ability to accommodate the ingrowing bone tissue in the SLM‐manufactured prototypes versus that in the corresponding CAD models has been quantitatively determined. Obtained results enabled to establish a way of compensatory structural‐geometric functionalization, allowing the MSC‐Scaffold adequate redesigning and manufacturing in additive SLM technology.

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Shabani, Ilir, Milan Samardziski, Viktor Kamnar, Neron Popovski, Antonio Gavrilovski, and Shaban Memeti. "Monitoring the reduction and maintenance of periprosthetic bone tissue in cementless primary hip endoprosthesis with alendronate therapy." Archives of Public Health 13, no. 2 (November 20, 2021): 69–77. http://dx.doi.org/10.3889/aph.2021.6002.

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Loss of periprosthetic bone tissue in primary hip endoprostheses is common in clinical practice. This loss can be progressive and in extreme conditions can jeopardize the longevity of the prosthesis. In order to monitor the function of Alendronate therapy for bone maintenance, the study included 50 patients with implanted total cement-free hip endoprosthesis (TPH). The first group of 25 patients received Alendronate, calcium and vitamin D3 orally postoperatively. The second group of 25 patients were examined postoperatively without therapy. Patients were followed by radiographic and dual-energy X-ray absorptiometry (DXA) at 6 and 12 months. The study showed that in patients with TPH there was a difference in the X-ray findings as well as occurrence of osteolysis in certain Gruen zones, which was confirmed by changes in the state of bone mineral density (BMD) and bone mineral content (BMC) in the interval between 6 and 12 months using the DXA method. Alendronate therapy after TPH implantation allows reduction of periprosthetic bone mass loss, maintenance of bone mineralization and implant hardening.

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Blunn, Gordon W., Timothy W. R. Briggs, Stephen R. Cannon, Peter S. Walker, Paul S. Unwin, Simon Culligan, and Justin P. Cobb. "Cementless Fixation for Primary Segmental Bone Tumor Endoprostheses." Clinical Orthopaedics and Related Research 372 (March 2000): 223–30. http://dx.doi.org/10.1097/00003086-200003000-00024.

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Neel, Michael D., and G. Douglas Letson. "Modular Endoprostheses for Children with Malignant Bone Tumors." Cancer Control 8, no. 4 (July 2001): 344–48. http://dx.doi.org/10.1177/107327480100800406.

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Stevenson, J. D., V. S. Kumar, G. L. Cribb, and P. Cool. "Hemiarthroplasty proximal femoral endoprostheses following tumour reconstruction." Bone & Joint Journal 100-B, no. 1 (January 2018): 101–8. http://dx.doi.org/10.1302/0301-620x.100b1.bjj-2017-0005.r1.

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AimsDislocation rates are reportedly lower in patients requiring proximal femoral hemiarthroplasty than for patients undergoing hip arthroplasty for neoplasia. Without acetabular replacement, pain due to acetabular wear necessitating revision surgery has been described. We aimed to determine whether wear of the native acetabulum following hemiarthroplasty necessitates revision surgery with secondary replacement of the acetabulum after proximal femoral replacement (PFR) for tumour reconstruction.Patients and MethodsWe reviewed 100 consecutive PFRs performed between January 2003 and January 2013 without acetabular resurfacing. The procedure was undertaken in 74 patients with metastases, for a primary bone tumour in 20 and for myeloma in six. There were 48 male and 52 female patients, with a mean age of 61.4 years (19 to 85) and median follow-up of two years (interquartile range (IQR) 0.5 to 3.7 years). In total, 52 patients presented with a pathological fracture and six presented with failed fixation of a previously instrumented pathological fracture.ResultsAll patients underwent reconstruction with either a unipolar (n = 64) or bipolar (n = 36) articulation. There were no dislocations and no acetabular resurfacings. Articular wear was graded using the criteria of Baker et al from 0 to 3, where by 0 is normal; grade 1 represents a narrowing of articular cartilage and no bone erosion; grade 2 represents acetabular bone erosion and early migration; and grade 3 represents protrusio acetabuli. Of the 49 patients with radiological follow-up greater than one year, six demonstrated grade 1 acetabular wear and two demonstrated grade 2 acetabular wear. The remainder demonstrated no radiographic evidence of wear. Median medial migration was 0.3 mm (IQR -0.2 to 0.7) and superior migration was 0.3 mm (IQR -0.2 to 0.6). No relationship between unipolar versus bipolar articulations and wear was evident.ConclusionHemiarthroplasty PFRs for tumour reconstruction eliminate joint instability and, in the short to medium term, do not lead to native acetabular wear necessitating later acetabular resurfacing. Cite this article: Bone Joint J 2018;100B:101–8.

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Kozinn, Stuart C., Norman A. Johanson, and Peter G. Bullough. "The biologic interface between bone and cementless femoral endoprostheses." Journal of Arthroplasty 1, no. 4 (January 1986): 249–59. http://dx.doi.org/10.1016/s0883-5403(86)80015-8.

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YANG, RONG-SEN. "THE APPLICATION OF EXPANDABLE ENDOPROSTHETIC RECONSTRUCTION FOR LIMB SALVAGE SURGERY IN THE SKELETALLY IMMATURE PATIENTS." Biomedical Engineering: Applications, Basis and Communications 13, no. 03 (June 25, 2001): 141–47. http://dx.doi.org/10.4015/s1016237201000182.

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The development of new image techniques enables the early detection of bone tumors in the extremities in the past two decades. In addition, new advance of adjuvant therapy improves the long-term survival of patients with primary bone malignancies. Since the primary bone malignancy frequently occurs at the metaphysis of long bones of pediatric patients in the first and second decade, many patients have to face the late problems of limb length discrepancy after the limb salvage operation. Since the inevitable limb length discrepancy will interfere the functional outcomes and cosmetic appearance, the reconstruction of limb defect after limb salvage remains a challenge. Several options of reconstruction are available for these patients, including resection arthrodesis, rotationplasty, osteochondral allograft reconstruction, and endoprosthetic reconstruction. All these methods are difficult to address the limb length discrepancy. The development of expandable endoprosthetic reconstruction makes limb-salvage surgery feasible in the skeletally immature and provides another choice of solution. This article presents the current status of custom-expandable endoprosthetic reconstruction in the skeletally immature patients after wide resection of primary bone malignancies in the extremity. The surgical options, complications and functional results will be emphasized. Basically these expandable endoprostheses can be classified according to the expansion design. Recent reports demonstrated that the results of expandable prosthesis in the growing children are rather acceptable. Some patients can regain the equal limb length after expansion of the prosthesis. However these patients have to take several expansion procedures for the equality of limb length during the growing period. A rather high complication rate of either endoprosthesis-related or disease-associated still needs to be settled in the near future. These include mechanical failure of the expansion mechanism, extensive metallosis, aseptic loosening, fatigue fracture, flexion contracture, local recurrence, delayed wound healing, fat embolism, local overgrowth of counterpart bone, nerve palsy, infection, and bone fracture. Some patients even require an amputation even after expandable endoprosthesis reconstruction because of difficult reconstruction or severe functional impairment. However, with regard to difficult rehabilitation for patients under 8 years, amputation or alternative options need to be considered. A comprehensive discussion with the parents and patient about the detailed treatment protocol is needed before performing reconstruction using expandable endoprosthesis.

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Haddad, F. S. "Corrigenda/Errata." Bone & Joint Journal 96-B, no. 4 (April 2014): 562. http://dx.doi.org/10.1302/0301-620x.96b4.34036e.

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Kim, Sungmin, Changhyun Ryu, and Sung-Taek Jung. "Differences in Kinematic and Kinetic Patterns According to the Bone Tumor Location after Endoprosthetic Knee Replacement Following Bone Tumor Resection: A Comparative Gait Analysis between Distal Femur and Proximal Tibia." Journal of Clinical Medicine 10, no. 18 (September 10, 2021): 4100. http://dx.doi.org/10.3390/jcm10184100.

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Modular endoprostheses are frequently used to reconstruct skeletal and knee defects from bone tumor resection and preserve joint function in patients with bone tumors around the knee. Depending on the tumor location, the muscles and extent of the tumor can vary, which can affect gait function. This study aimed to analyze kinetic and kinematic characteristics according to tumor location in patients with endoprosthetic knee replacements after bone tumor resection. Gait analyses were performed in 16 patients who underwent knee endoprosthesis due to tumors around the knee. We divided the patients into distal femur (n = 7) and proximal tibia (n = 9) groups and conducted between-group comparisons and comparisons with healthy participants. Compared with the control group, the distal femur group showed a tendency for knee extension, and the proximal tibia group showed increased maximal dorsiflexion during stance. The proximal tibia group maintained a flexed hip during the entire gait cycle, compared with the distal femur group. In summary, our results suggest a difference in gait between the distal femur and proximal tibia groups. Patients who have undergone knee prosthesis after knee tumor resection may require different rehabilitation strategies according to the tumor location.

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Karpiński, Robert, Jakub Szabelski, Przemysław Krakowski, and Józef Jonak. "Effect of Physiological Saline Solution Contamination on Selected Mechanical Properties of Seasoned Acrylic Bone Cements of Medium and High Viscosity." Materials 14, no. 1 (December 29, 2020): 110. http://dx.doi.org/10.3390/ma14010110.

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Bone cements play a key role in present-day surgery, including the implantation of hip and knee joint endoprostheses. The correct and durable bonding of the prosthesis to the bone is affected by both the static strength characteristics determined in accordance with ISO 5833:2002 and the resistance to long-term exposure to an aggressive environment of the human body and the impurities that may be introduced into the cement during implementation. The study attempts to demonstrate statistically significant degradation of cement as a result of the seasoning of cement samples in Ringer’s solution with simultaneous contamination of the material with saline solution, which is usually present in the surgical field (e.g., during the fixing of endoprostheses). The results of statistical analysis showed the nature of changes in compressive strength and microhardness due to seasoning time and degree of contamination.

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Ayoub, K. S., F. Fiorenza, R. J. Grimer, R. M. Tillman, and S. R. Carter. "Extensible endoprostheses of the humerus after resection of bone tumours." Journal of Bone and Joint Surgery. British volume 81-B, no. 3 (May 1999): 495–500. http://dx.doi.org/10.1302/0301-620x.81b3.0810495.

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Kuzmin, I. I. "Pathogenetic features of the infectious process in traumatology and orthopedics." N.N. Priorov Journal of Traumatology and Orthopedics 7, no. 4 (March 17, 2022): 67–71. http://dx.doi.org/10.17816/vto104588.

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Infections of the osteoarticular system are among the most difficult to diagnose and treat, due to a number of factors: morphological and functional characteristics of the bone matrix [29]; frequent use of various abiogenic materials (metal structures, endoprostheses, bone grafts, cements [21,22], etc.); polymicrobial nature of the colonizing microflora; latent clinical course, which leads to delayed diagnosis.

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Hodge, Susan C., Daniel Degner, Richard Walshaw, and Brian Teunissen. "Vascularized Ulnar Bone Grafts for Limb-Sparing Surgery for the Treatment of Distal Radial OsteosarcomaS." Journal of the American Animal Hospital Association 47, no. 2 (March 1, 2011): 98–111. http://dx.doi.org/10.5326/jaaha-ms-5504.

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The objective of this retrospective study was to compare vascularized free or roll-in ulnar bone grafts for limb-sparing surgery in dogs with radial osteosarcoma with the cortical allograft, metal endoprosthesis, or distraction osteogenesis techniques. Overall, the ulnar graft techniques used in this study demonstrated excellent healing properties. Complications included recurrence of the tumor in 25% (2/8) of the dogs, metastasis in 50% (4/8) of the dogs, implant loosening in 37.5% (3/8) of the dogs, implant failure in 12.5% (1/8) of the dogs, and infection in 62.5% (5/8) of the dogs. Mean survival time was 29.3 mo (range, 9 to 61 mo). The mean metastasis-free interval was 33.67 mo (range, 8 to 54 mo). Tumors recurred locally in two dogs at 10 mo and 20 mo postoperatively. This study yielded similar long-term complications as other limb-sparing options (such as cortical allografts and metal endoprostheses) and allowed dogs to bear weight on the operated limb with acceptable limb function. More research is needed regarding specific healing times for ulnar vascularized grafts, time until implant removal, and the extent of radial bone that could ultimately be replaced by the ulna.

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Park, D. H., P. K. Jaiswal, W. Al-Hakim, W. J. S. Aston, R. C. Pollock, J. A. Skinner, S. R. Cannon, and T. W. R. Briggs. "The Use of Massive Endoprostheses for the Treatment of Bone Metastases." Sarcoma 2007 (2007): 1–5. http://dx.doi.org/10.1155/2007/62151.

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Purpose. We report a series of 58 patients with metastatic bone disease treated with resection and endoprosthetic reconstruction over a five-year period at our institution.Introduction. The recent advances in adjuvant and neoadjuvant therapy in cancer treatment have resulted in improved prognosis of patients with bone metastases. Most patients who have either an actual or impending pathological fracture should have operative stabilisation or reconstruction. Endoprosthetic reconstructions are indicated in patients with extensive bone loss, failed conventional reconstructions, and selected isolated metastases.Methods and Results. We identified all patients who were diagnosed with metastatic disease to bone between 1999 and 2003. One hundred and seventy-one patients were diagnosed with bone metastases. Metastatic breast and renal cancer accounted for 84 lesions (49%). Fifty-eight patients with isolated bone metastasis to the appendicular skeleton had an endoprosthetic reconstruction. There were 28 males and 30 females. Twelve patients had an endoprosthesis in the upper extremity and 46 patients had an endoprosthesis in the lower extremity. The mean age at presentation was 62 years (24 to 88). At the time of writing, 19 patients are still alive, 34 patients have died, and 5 have been lost to follow up. Patients were followed up and evaluated using the musculoskeletal society tumour score (MSTS) and the Toronto extremity salvage score (TESS). The mean MSTS was 73% (57% to 90%) and TESS was 71% (46% to 95%). Mean follow-up was 48.2 months (range 27 to 82 months) and patients died of disease at a mean of 22 months (2 to 51 months) from surgery. Complications included 5 superficial wound infections, 1 aseptic loosening, 4 dislocations, 1 subluxation, and 1 case, where the tibial component of a prosthesis rotated requiring open repositioning.Conclusions. We conclude that endoprosthetic replacement for the treatment of isolated bone metastases is a reliable method of limb reconstruction in selected cases. It is associated with low complication and failure rates in our series, and achieves the aims of restoring function, allowing early weight bearing and alleviating pain.

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Grigorov, Serhii M., Anton K. Khudyk, and Iryna S. Sukhina. "APPLIANCE OF CAD / CAM MODELING IN PROSTHETICS OF BONE DEFECTS OF FACIAL BONES." Wiadomości Lekarskie 74, no. 6 (2021): 1469–74. http://dx.doi.org/10.36740/wlek202106133.

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The aim: Improving the ability to restore the shape and function of the bones of the maxillofacial area through the use of their own techniques. Materials and methods: Materials and methods: This research was carry out on the basis of the Department of Surgical Dentistry and Maxillofacial Surgery of Kharkov National Medical University in the Department of Head and Neck Surgery, Kharkov “Regional Clinical Hospital” (2018-2020 years). Examination and treatment of 26 patients, aged from 19 to 55 years, who needed reconstructive surgery to restore the anatomical shape, integrity and function of the maxilla or mandibular jaw. Results: All patients were treated according to the developed method (utility model patent № 145754 “Method of treating traumatic fractures of the maxillofacial area in adults using bone osteosynthesis 3D modeled titanium mini plates”), which consists in 3D modeling, based on previously performed computed tomography, and exploitation individually modeled titanium mini grids and titanium endoprostheses. The experience of this technique shown the advantage of the proposed method not only in the correction of traumatic defects, but also defects of the jaw bones that occur due to the removal of bulky neoplasms. Conclusions: Individual 3D simulated mini grids / plates and endoprostheses, according to the study provide maximum adaptation and restoration of anatomical shape, relief of jaws, their integrity and contour, provide prevention of pathological fractures by stabilizing residual bone tissue (titanium mini grids) serves as a carcass , provide prevention of prolapse (germination) of soft tissues in the area of postoperative bone defect (mini grid does not allow soft tissues to germinate in the area of postoperative bone defect on the outside), which improves functional and cosmetic results. Thus, our proposed method of osteosynthesis using 3D simulated titanium miniplates can be recommended for use in clinical practice.

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Kopysova, Valentina Afanas'evna, V. A. Kaplun, A. N. Svetashov, V. V. Shashkov, V. A. Kopysova, V. A. Kaplun, A. N. Svetashov, and V. V. Shashkov. "Methods of Reconstructive Surgical Treatment for Patients with Defects and Pseudarthroses of Femur." N.N. Priorov Journal of Traumatology and Orthopedics 17, no. 4 (December 15, 2010): 65–70. http://dx.doi.org/10.17816/vto201017465-70.

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Treatment results of 59 patients with femoral bone defects and diaphyseal pseudarthroses were analyzed. To substitute bone defects of more than 6 cm permeable porous endoprostheses were used. In patients with normotrophic and hypertrophic pseudarthrosis stable osteosynthesis with interfragmental compression of bone fragments by shape-memory-effect tightening bows was performed. In patients with atrophic pseudarthrosis bone plasty with autograft was applied. In all patients the weight-bearing ability of the affected limb was restored. Total restoration of function was achieved in 75.6% of patients.

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Dąbrowski, Mikołaj, Piotr Rogala, Ryszard Uklejewski, Adam Patalas, Mariusz Winiecki, and Bartosz Gapiński. "Subchondral Bone Relative Area and Density in Human Osteoarthritic Femoral Heads Assessed with Micro-CT before and after Mechanical Embedding of the Innovative Multi-Spiked Connecting Scaffold for Resurfacing THA Endoprostheses: A Pilot Study." Journal of Clinical Medicine 10, no. 13 (June 30, 2021): 2937. http://dx.doi.org/10.3390/jcm10132937.

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The multi-spiked connecting scaffold (MSC-Scaffold) prototype is the essential innovation in the fixation of components of resurfacing total hip arthroplasty (THRA) endoprostheses in the subchondral trabecular bone. We conducted the computed micro-tomography (micro-CT) assessment of the subchondral trabecular bone microarchitecture before and after the MSC-Scaffold embedding in femoral heads removed during long-stem endoprosthesis total hip arthroplasty (THA) of different bone densities from 4 patients with hip osteoarthritis (OA). The embedding of the MSC-Scaffold in subchondral trabecular bone causes the change in its relative area (BA/TA, bone area/total area ratio) ranged from 18.2% to 24.7% (translating to the calculated density ρB relative change 11.1–14.4%, and the compressive strength S relative change 75.3–122.7%) regardless of its initial density (before the MSC-Scaffold embedding). The densification of the trabecular microarchitecture of subchondral trabecular bone due to the MSC-Scaffold initial embedding gradually decreases with the increasing distance from the apexes of the MSC-Scaffold’s spikes while the spatial extent of this subchondral trabecular bone densification ranged from 1.5 to 2.5 mm (which is about half the height of the MSC-Scaffold’s spikes). It may be suggested, despite the limited number of examined femoral heads, that: (1) the magnitude of the effect of the MSC-Scaffold embedding on subchondral trabecular bone densification may be a factor contributing to the maintenance of the MSC-Scaffold also for decreased initial bone density values, (2) the deeper this effect of the subchondral trabecular bone densification, the better strength of subchondral trabecular bone, and as consequence, the better post-operative embedding of the MSC-Scaffold in the bone should be expected.

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Uklejewski, Ryszard, Mariusz Winiecki, Adam Patalas, and Piotr Rogala. "Bone Density Micro-CT Assessment during Embedding of the Innovative Multi-Spiked Connecting Scaffold in Periarticular Bone to Elaborate a Validated Numerical Model for Designing Biomimetic Fixation of Resurfacing Endoprostheses." Materials 14, no. 6 (March 12, 2021): 1384. http://dx.doi.org/10.3390/ma14061384.

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Our team has been working for some time on designing a new kind of biomimetic fixation of resurfacing endoprostheses, in which the innovative multi-spiked connecting scaffold (MSC-Scaffold) that mimics the natural interface between articular cartilage and periarticular trabecular bone in human joints is the crucial element. This work aimed to develop a numerical model enabling the design of the considered joint replacement implant that would reflect the mechanics of interacting biomaterials. Thus, quantitative micro-CT analysis of density distribution in bone material during the embedding of MSC-Scaffold in periarticular bone was applied. The performed numerical studies and corresponding mechanical tests revealed, under the embedded MSC-Scaffold, the bone material densification affecting its mechanical properties. On the basis of these findings, the built numerical model was modified by applying a simulated insert of densified bone material. This modification led to a strong correlation between the re-simulation and experimental results (FVU = 0.02). The biomimetism of the MSC-Scaffold prototype that provided physiological load transfer from implant to bone was confirmed based on the Huber–von Mises–Hencky (HMH) stress maps obtained with the validated finite element (FE) model of the problem. The micro-CT bone density assessment performed during the embedding of the MSC-Scaffold prototype in periarticular bone provides insight into the mechanical behaviour of the investigated implant-bone system and validates the numerical model that can be used for the design of material and geometric features of a new kind of resurfacing endoprostheses fixation.

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Belthur, Mohan V., Rob J. Grimer, Rajeev Suneja, Simon R. Carter, and Roger M. Tillman. "Extensible Endoprostheses for Bone Tumors of the Proximal Femur in Children." Journal of Pediatric Orthopaedics 23, no. 2 (March 2003): 230–35. http://dx.doi.org/10.1097/01241398-200303000-00018.

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Davies, Benjamin, Rajiv Kaila, Loukas Andritsos, Christian Gray Stephens, Gordon W. Blunn, Craig Gerrand, Panagiotis Gikas, and Andrew Johnston. "Osteointegration of hydroxyapatite-coated collars in cemented massive endoprostheses following revision surgery." Bone & Joint Open 2, no. 6 (June 1, 2021): 371–79. http://dx.doi.org/10.1302/2633-1462.26.bjo-2021-0017.r1.

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Aims Hydroxyapatite (HA)-coated collars have been shown to reduce aseptic loosening of massive endoprostheses following primary surgery. Limited information exists about their effectiveness in revision surgery. The aim of this study was to radiologically assess osteointegration to HA-coated collars of cemented massive endoprostheses following revision surgery. Methods Retrospective review of osseointegration frequency, pattern, and timing to a specific HA-coated collar on massive endoprostheses used in revision surgery at our tertiary referral centre between 2010 to 2017 was undertaken. Osseointegration was radiologically classified on cases with a minimum follow-up of six months. Results In all, 39 patients underwent radiological review at mean 43.5 months; 22/39 (56.4%) showed no osseointegration to the collar. Revision endoprostheses for aseptic loosening were less likely to show osseointegration compared with other indications for revision. Oncological cases with previous or current infection were more likely to show osseointegration to ≥ 1 collar side than those without evidence of prior infection. Conclusion This seven-year review identified osseointegration of HA-coated collars after revision surgery is less likely (43.6%, 17/39) than after primary surgery. Young patients who undergo revision surgery following initial oncological indication may benefit the most from this collar design. Use in revision oncological cases with a history of infection may be beneficial. HA-coated collars showed limited benefit for patients undergoing revision for failed arthroplasty with history of infection. Cite this article: Bone Jt Open 2021;2(6):371–379.

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Iluridze, G. D., V. Yu Karpenko, V. A. Derzhavin, and A. V. Bukharov. "THE RESULTS OF MODULAR ENDOPROSTHESIS OF PERIACETABULAR REGION IN TUMOR LESIONS OF THE ACETABULUM AND HIP JOINT." Research'n Practical Medicine Journal 6, no. 2 (June 28, 2019): 20–31. http://dx.doi.org/10.17709/2409-2231-2019-6-2-2.

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Surgical treatment of patients with tumoral defeat of pelvic bones, of preacetabular region, in particular, is one of the most challenging topics of modern oncorthopedics. Currently, one of the most modern methods of reconstruction of the pelvic bones is the use of modular endoprostheses based on the conical leg, the advantage of which is the ability to intraoperatively simulate an endoprosthesis that best meets the specific clinical situation. Purpose of research. To assess the benefits of modular endoprosthesis of the acetabulum in patients with tumoral defeat periacetabular region.Patients and methods. Within the period of 2011–2018 30 patients underwent surgical treatment in form of periacetabular resection with a modular endoprosthesis reconstruction in P.Hertsen Moscow Oncology Research Institute – Branch of National Medical Research Radiological Centre of Ministry of Health of Russian Federation. There were 13 men (43%) and 17 women (57%). The median age was 45 years (23–63 years). Primary bone cancers were in 19 (63%) patients, giant cell tumors in 5 (17%), locally advanced soft tissue sarcoma in 1 (3%), solitary metastases of kidney cancer in 2 (7%), and recurrent sarcomas after previous surgical treatment in 3 (10%) patients.Results. The average duration of the operation was 310 min (145–520 min), the volume of intraoperative blood loss was 5520 ml (600–20 000 ml). The positive edge of resection according to the results of the planned morphological study was revealed in 3 (10%) patients. The average follow-up period was 36 months (4-73 months). Disease progression in terms of 6 to 40 months was revealed in 10 (33%) patients. 8 (27%) patients from disease progression. Complications of different types were diagnosed in 11 (37%) patients, among whom infectious complications prevailed 9 (30%). The average value of the functional results on a scale MSTS accounted for 59% (15 to 82%). Conclusion. The use of modular systems of endoprosthesis replacement of the acetabulum and hip joint in tumor lesions is a promising surgical technique that allows to achieve adequate functional results with a comparable number of postoperative complications.

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Gilg, M. M., C. L. Gaston, L. Jeys, A. Abudu, R. M. Tillman, J. D. Stevenson, R. J. Grimer, and M. C. Parry. "The use of a non-invasive extendable prosthesis at the time of revision arthroplasty." Bone & Joint Journal 100-B, no. 3 (March 2018): 370–77. http://dx.doi.org/10.1302/0301-620x.100b3.bjj-2017-0651.r1.

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Aims The use of a noninvasive growing endoprosthesis in the management of primary bone tumours in children is well established. However, the efficacy of such a prosthesis in those requiring a revision procedure has yet to be established. The aim of this series was to present our results using extendable prostheses for the revision of previous endoprostheses. Patients and Methods All patients who had a noninvasive growing endoprosthesis inserted at the time of a revision procedure were identified from our database. A total of 21 patients (seven female patients, 14 male) with a mean age of 20.4 years (10 to 41) at the time of revision were included. The indications for revision were mechanical failure, trauma or infection with a residual leg-length discrepancy. The mean follow-up was 70 months (17 to 128). The mean shortening prior to revision was 44 mm (10 to 100). Lengthening was performed in all but one patient with a mean lengthening of 51 mm (5 to 140). Results The mean residual leg length discrepancy at final follow-up of 15 mm (1 to 35). Two patients developed a deep periprosthetic infection, of whom one required amputation to eradicate the infection; the other required two-stage revision. Implant survival according to Henderson criteria was 86% at two years and 72% at five years. When considering revision for any cause (including revision of the growing prosthesis to a non-growing prosthesis), revision-free implant survival was 75% at two years, but reduced to 55% at five years. Conclusion Our experience indicates that revision surgery using a noninvasive growing endoprosthesis is a successful option for improving leg length discrepancy and should be considered in patients with significant leg-length discrepancy requiring a revision procedure. Cite this article: Bone Joint J 2018;100-B:370–7.

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Ehrhardt, J., W. Plötz, S. J. Pöppl, and H. Handels. "Simulation of Hip Operations and Design of Custom-made Endoprostheses using Virtual Reality Techniques." Methods of Information in Medicine 40, no. 02 (2001): 74–77. http://dx.doi.org/10.1055/s-0038-1634467.

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AbstractIn this paper a system for the virtual planning of hip operations with endoprosthetic reconstruction and its application in bone tumor surgery is described. The system enables the simulation of the operation and the construction of a custom-made implant depending on the chosen resection planes and the patient’s anatomy. During the planning process integrated virtual reality techniques facilitate the interaction with the three-dimensional (3D) medical objects. Stereo viewing improves the perception of the 3D nature of bone structures and tumors. In comparison to conventional planning procedures, different operation strategies and their influence on the geometry of the custom-made endoprosthesis can be easily compared. Furthermore, the combination of multi-modal image information (CT and MR) enables an accurate 3D visualization of the bone tumor within the bone.

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Аносов, А. В., and A. V. Anosov. "Research of Mechanical Characteristics of Bone Tissues By Means Of the Developed Automated System of Medical Appointment." Mathematical Biology and Bioinformatics 10, no. 2 (December 4, 2015): 548–61. http://dx.doi.org/10.17537/2015.10.548.

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The presented system of medical appointment allows building of solid-state models of bone and soft tissues on the basis of computer tomogram data. These models are able to take into account anisotropy of biomechanical properties, to carry out multiple geometrical operations on association of models of bone tissues with various combinations of fixing systems and endoprostheses, to calculate their mechanical characteristics in various physical environments, to carry out the comparative analysis of results of the calculation. The system provides biomechanical justifications of effective methods of diagnostics and treatment of the human musculoskeletal device.

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Elalfy, Mohammad A., Patrick J. Boland, and John H. Healey. "Chemotherapy Curtails Bone Formation From Compliant Compression Fixation of Distal Femoral Endoprostheses." Clinical Orthopaedics and Related Research 477, no. 1 (January 2019): 206–16. http://dx.doi.org/10.1097/corr.0000000000000512.

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Vyrva, O. Ye, I. O. Skoryk, and V. D. Tovazhnianska. "Modular endoprosthetic replacement for proximal tibia tumor patients." Zaporozhye Medical Journal 23, no. 2 (April 16, 2021): 242–49. http://dx.doi.org/10.14739/2310-1210.2021.2.224920.

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The major method of malignant bone tumors treatment is surgery. The most important task of an orthopedic surgeon is to preserve an adjacent joint. Currently, there are a large number of various reconstructive surgeries, including structural bone allograft, allocomposite and modular endoprosthetics replacement. The aim: to analyze the results of surgical treatment for proximal tibia malignant tumors using modular endoprosthesis. Materials and methods. The results of proximal tibia (PT) modular endoprosthetic replacement in 48 patients with PT tumor lesions were evaluated. The patients were divided into two groups: I (n = 36) – tumor resection and primary modular endoprosthesis, II (n = 12) – revision modular endoprosthetic replacement due to complications. Complications were divided into oncological, mechanical and non-mechanical. The functional outcomes were measured using the MSTS and TESS scores. Results. During the treatment, 10 (21.2 %) patients underwent myofascioplastic amputation at the middle third of the thigh: due to periprosthetic infection – 8 people and tumor recurrence – 2. It was found that the patients got back to regular way of life on average in 2.0–2.5 months. Functional results on the MSTS score were 73 ± 12 %, on the TESS score – 74 ± 16 %, which corresponds to good functional results. Among the patients, who underwent limb salvage surgery, no tumor recurrence was detected during a follow-up period from 6 months up to 11 years. Conclusions. The choice of surgical treatment depends on the size of tumor, its location, pathohistomorphological picture, age, presence of pathological fractures, vascular and nerve tumor invasion. The use of modern designs of PT modular tumor endoprostheses and perfect surgeries makes it possible to minimize complications.

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44

Uklejewski, Ryszard, Piotr Rogala, Mariusz Winiecki, Andrzej Kędzia, and Piotr Ruszkowski. "Preliminary Results of Implantation in Animal Model and Osteoblast Culture Evaluation of Prototypes of Biomimetic Multispiked Connecting Scaffold for Noncemented Stemless Resurfacing Hip Arthroplasty Endoprostheses." BioMed Research International 2013 (2013): 1–10. http://dx.doi.org/10.1155/2013/689089.

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We present the new fixation method for RHA(resurfacing hip arthroplasty)endoprostheses by means of the biomimetic multispiked connecting scaffold (MSC-Scaffold). Such connecting scaffold can generate new type of RHA endoprostheses, that is stemless and fixed entirely without cement. The preprototypes of this MSC-Scaffold were manufactured with modern additive laser additive technology (SLM). The pilot surgical implantations in animal model (two laboratory swine) of MSC-Scaffold preprototypes have showed after two months neither implant loosening, migration, and nor other early complications. From the results of performed histopathological evaluation of the periscaffold spikes bone tissue and 10-day culture of human osteoblasts (NHOst) we can conclude that (1) the scaffolding effect was obtained and (2) to improve the osseointegration of the scaffold spikes, their material surface should be physicochemically modified (e.g., with hydroxyapatite). Some histopathological findings in the periscaffold domain near the MSC-Scaffold spikes bases (fibrous connective tissue and metallic particles near the MSC-Scaffold spikes bases edges) prompt considering the necessity to optimize the design of the MSC-Scaffold in the regions of its interspike space near the spikes bases edges, to provide more room for new bone formation in this region and for indispensable post-processing (glass pearl blasting) after the SLM manufacturing.

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45

Anderson, G. I. "Polymethylmethacrylate: a Review of the Implications and Complications of its Use in Orthopaedic Surgery." Veterinary and Comparative Orthopaedics and Traumatology 01, no. 02 (April 1988): 74–79. http://dx.doi.org/10.1055/s-0038-1633168.

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Polymethylmethacrylate has application in the fixation of endoprostheses and void-filling in reconstructive and neurological surgery in both veterinary and human surgery. It also has extensive dental and ophthalmic applications. Literature detailing the nature of the bone/cement interface is reviewed along with the local effect of polymethylmethacrylate on bone and cartilage. The repercussions of the cellular effects of polymethylmethacrylate on the development of loosening are discussed. The immunosuppressive effects of polymethylmethacrylate to the patient are outlined. A review of the cardiovascular, pulmonary and hepatic toxicity problems of polymethylmethacrylate is included. Contact sensitisation of the user is briefly discussed in conclusion.

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46

De Gori, Marco, Guido Scoccianti, Filippo Frenos, Leonardo Bettini, Filippo Familiari, Giorgio Gasparini, Giovanni Beltrami, Pierluigi Cuomo, Pietro De Biase, and Rodolfo Capanna. "Modular Endoprostheses for Nonneoplastic Conditions: Midterm Complications and Survival." BioMed Research International 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/2606521.

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The use of modular endoprostheses is a viable option to manage both tumor resection and severe bone loss due to nonneoplastic conditions such as fracture sequelae, failed osteoarticular grafts, arthroplasty revisions, and periprosthetic fractures. We sought to investigate both midterm complications and failures occurred in 87 patients who underwent a megaprosthetic reconstruction in a nonneoplastic setting. After a mean follow-up of 58 (1–167) months, overall failure-free survival was 91.5% at 1 year, 80% at 2 years, 71.6% at 5 years, and 69.1% at 5 and 10 years. There was no significant difference in the survival rate according to the diagnosis at the index procedure (p=0.921), nor to the reconstruction site (p=0.402). The use of megaprostheses in a postneoplastic setting did not affect survival rate in comparison with endoprosthetic reconstruction of pure nonneoplastic conditions (p=0.851). Perimegaprosthetic infection was the leading complication, occurring in 10 (11.5%) patients and implying a megaprosthetic revision in all but one case. Physicians should consider these results when discussing with patients desired outcomes of endoprosthetic reconstructions of a nonneoplastic disease.

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47

Shin, Duk-Seop, Peter F. M. Choong, Edmund Y. H. Chao, and Franklin H. Sim. "Large tumor endoprostheses and extracortical bone-bridging: 28 patients followed 10-20 years." Acta Orthopaedica Scandinavica 71, no. 3 (January 2000): 305–11. http://dx.doi.org/10.1080/000164700317411933.

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48

Makhson, A. N. "Replacement of extensive bone defects in patients with locomotor system tumors." N.N. Priorov Journal of Traumatology and Orthopedics 1, no. 4 (March 21, 2022): 18–21. http://dx.doi.org/10.17816/vto105148.

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The paper discusses the problem in replacing extensive bone defects after adequate resections in patients with locomotor system tumors, defines a concept of an adequate operation, and provides an original classification of osteotumors by the extent of a tumorous process. After extirpation of the clavicle (including resection of the manubrium sterni and the first rib), scapulectomy, inter-scapulothoracic, pelvic, and proximal fibular resections, the author does not replace bone defects, without deteriorating the surgical functional outcomes. In 135 patients, defects were replaced by variously designed endoprostheses (in 23 of them this was done after total removal of the femur or humerus). Postendoprosthetic complications developed in 14 patients: early suppuration (n = 3), metallosis and late suppuration (n = 3), endoprosthetic fracture (n = 5), and intraoperative bone fracture (n = 3). Bone fracture occurred while mastering the procedure and failed to affect therapeutical functional results. In extensive long bone diaphysial defects and combined bone and soft tissue defects, the author used autografting on micro-vascular anastomoses in 34 patients or defect replacement in the Ilizarov apparatus in 8 patients.

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Bulgakov, Valeriy Georgievich, V. K. Il'ina, N. S. Gavryushenko, A. N. Shal'nev, N. P. Omel'yanenko, V. G. Bulgakov, V. K. Il'ina, N. S. Gavryushenko, A. N. Shal'nev, and N. P. Omel'yanenko. "Tribochemical Component of Oxidative Stress Development when Implantating of Artificial Joints. Part 2. Oxidative and Antiproliferative Effect of Wear Debris of Orthopedic Materials." N.N. Priorov Journal of Traumatology and Orthopedics 17, no. 3 (September 15, 2010): 29–33. http://dx.doi.org/10.17816/vto201017329-33.

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Using modeling reaction with constant production of metal radical-generated wear debris it was determined increasing intensification of oxidative processes. Generated free radicals enabled to oxidize polymeric component of endoprostheses. Radical-generated wear debris significantly decreased the proliferative ability of human osteogenic cells. Inert ceramics particles showed antiprolifirative effect only in their high concentration. Those particles prevented growth of osteogenic cells. Worsening in mechanical properties of polymeric implant components and disturbance of bone remodeling under radical-generated wear debris may be one of the causes of further development of implant loosening and its instability.

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Foukas, Athanasios F., and Robert J. Grimer. "Bilateral Endoprosthetic Replacements of the Proximal Femur." Sarcoma 2, no. 1 (1998): 49–51. http://dx.doi.org/10.1080/13577149878163.

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Patient.We report the case of a 20-year-old caucasian male with an Ewing's sarcoma in the left upper femur. After induction chemotherapy, he underwent resection of the left upper femur and insertion of a cemented proximal femoral replacement. Four years later, he presented with a solitary bone metastasis in the right upper femur. He underwent further chemotherapy followed by resection and endoprosthetic replacement of the other proximal femur. He remains disease free with excellent function almost a year after the second operation.Discussion.We believe this is the first reported case of bilateral proximal femoral endoprostheses.

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