The medium-term results of the Stanmore non-invasive extendible endoprosthesis in the treatment of paediatric bone tumours

J Bone Joint Surg Br. 2012 Mar;94(3):425-30. doi: 10.1302/0301-620X.94B3.27738.

Abstract

In skeletally immature patients, resection of bone tumours and reconstruction of the lower limb often results in leg-length discrepancy. The Stanmore non-invasive extendible endoprosthesis, which uses electromagnetic induction, allows post-operative lengthening without anaesthesia. Between 2002 and 2009, 55 children with a mean age of 11.4 years (5 to 16) underwent reconstruction with this prosthesis; ten patients (18.2%) died of disseminated disease and one child underwent amputation due to infection. We reviewed 44 patients after a mean follow-up of 41.2 months (22 to 104). The mean Musculoskeletal Tumor Society score was 24.7 (8 to 30) and the Toronto Extremity Salvage score was 92.3% (55.2% to 99.0%). There was no local recurrence of tumour. Complications developed in 16 patients (29.1%) and ten (18.2%) underwent revision. The mean length gained per patient was 38.6 mm (3.5 to 161.5), requiring a mean of 11.3 extensions (1 to 40), and ten component exchanges were performed in nine patients (16.4%) after attaining the maximum lengthening capacity of the implant. There were 11 patients (20%) who were skeletally mature at follow-up, ten of whom had equal leg lengths and nine had a full range of movement of the hip and knee. This is the largest reported series using non-invasive extendible endoprostheses after excision of primary bone tumours in skeletally immature patients. The technique produces a good functional outcome, with prevention of limb-length discrepancy at skeletal maturity.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Bone Lengthening / instrumentation*
  • Bone Lengthening / methods
  • Bone Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Female
  • Femur / diagnostic imaging
  • Femur / surgery
  • Follow-Up Studies
  • Growth
  • Humans
  • Knee Joint / physiopathology
  • Leg Length Inequality / etiology
  • Leg Length Inequality / prevention & control
  • Limb Salvage / methods
  • Lower Extremity / surgery*
  • Male
  • Prostheses and Implants*
  • Prosthesis Design
  • Prosthesis Implantation / adverse effects
  • Prosthesis Implantation / methods
  • Radiography
  • Range of Motion, Articular
  • Reoperation / methods
  • Tibia / diagnostic imaging
  • Tibia / surgery
  • Treatment Outcome