Page 183 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

MUTARS knee replacement
( ve of 17 [29%]) and primary reconstructions (eight of 61 [13%]) (hazard ratio [HR], 1.72; 95% CI, 0.55 – 5.38; p = 0.354). Hydroxyapatite-coated uncemented implants had a lower risk of loosening (two of 42 [5%]) than uncoated uncemented implants (11 of 36 [31%]) (HR, 0.23; 95% CI, 0.05 – 1.06; p = 0.060). Structural complications occurred in 15 reconstructions (15 of 110 [14%]). Infections occurred in 14 reconstructions (14 of 110 [13%]). Ten patients had a local recurrence (10 of 101 [10%]). With failure for mechanical reasons as the endpoint, the cumulative incidences of implant failure at ve, ten, and 15 years were 16.9% (95% CI, 9.6 – 24.2), 20.7% (95% CI, 12.5 – 28.8%), and 37.9% (95% CI, 16.1 – 59.7), respectively. We were able to salvage some of the failures so that at follow-up, 90 patients (90 of 101 [89%]) had a MUTARS in situ.
Conclusions: Although no system has yet proved ideal to restore normal function and demonstrate long-term retention of the implant, MUTARS modular endoprostheses represent a reliable long-term option for knee replacement after tumor resection, which seems to be comparable to other modular implants available to surgeons. Although the number of patients is relatively small, we could demonstrate that with this prosthesis, an uncemented HA-coated implant is useful in achieving durable xation.
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