COMPLICATIONS  AND SURVIVAL OUTCOME  FOLLOWING CUSTOM MEGA PROSTHESIS RECONSTRUCTION FOR BONE TUMOURSA SINGLE INSTITUTION  15 YEARS  STUDY.

Prof Subbiah Shanmugam; Dr Sujay Susikar; Dr Satish kumar Maheswaran

Volume : V, Issue : IX, September - 2016

COMPLICATIONS AND SURVIVAL OUTCOME FOLLOWING CUSTOM MEGA PROSTHESIS RECONSTRUCTION FOR BONE TUMOURSA SINGLE INSTITUTION 15 YEARS STUDY.

Prof Subbiah Shanmugam, Dr Sujay Susikar, Dr Satish Kumar Maheswaran

Abstract :

Limb salvage surgery has become the standard of care in the management of extremity bone tumours. In a resource limited settings like our�s, custom made megaprosthesis provides an excellent option for limb salvage surgery. Aims And Objectives: To analyse, the various complications, rates of implant survival, median survival in patients undergoing custom megaprosthesis reconstruction for extremity bone tumours . Materials And Methods: Fifty eight patients who underwent custom megaprosthesis reconstruction in our �Centre for Oncology�, between 2002 and 2016 for extremity bone tumours were analysed using kaplan Meier analysis and log rank test.Results: Type I Failure(Soft tissue) –I. Joint instability was observed in 24 patients(42%), with median time of occurrence at 3.7 months, II Aseptic wound dehiscence /superficial infection was observed in 19 (33.3%), with median time of 10 days. Type III (structural)failure in form of prosthesis fracture was seen in 4 patients(7.01%). Disclocation of the implanted prosthesis occurred in 3 patients(5.26%) Deep infection(Type IV) occurred in 3 patients (5.2%) .Our Implant survival rate was 89.48%. Local reccurence(Type V) occurred in 4 patients (7.01%),median time 11.2months, distal recurrence(lung metastasis) was observed in 13 patients(22.80%), with median time to occurrence of 19.3months. Median survival for lower extremity sarcoma was 28.3months and upper extremity sarcoma was 31.9months. Conclusion:From our study,we found that Type I failure in form of joint instability and aseptic wound dehiscence are commonest complications .