Page 193 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Implant Failure Rates
With failure for mechanical reasons (types 1 – 3) 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 ( gure 3). With failure for infection (type 4) as the endpoint, these were 7.9% (95% CI, 2.7 – 13.2), 10.0% (95% CI, 3.5 – 16.4), and 10.0% (95% CI, 3.5 – 16.4), respectively. With failure from tumor progression (type 5) as the endpoint, these were 5.0% (95% CI, 0.7 – 9.2), 6.2% (95% CI, 1.4 – 11.0), and 6.2% (95% CI, 1.4 – 11.0), respectively. None of the assessed variables (extra-articular resection, HA coating of uncemented implants, reconstruction length of > 16 cm, adjuvant therapy, or having a preceding reconstruction) was found to have been associated with di erences in implant survival in univariable Cox regression analyses.
MUTARS knee replacement
Figure 3. Competing-risk analyses of implant failure. This plot shows the cumulative incidence of mechanical failure (type 1 – 3), infection (type 4), and tumor progression (type 5). Patient mortality was used as a competing event in these analyses.
Limb Salvage
Limb salvage was achieved in 91 patients (90%). In total, 64 of 101 patients had their original MUTARS in situ without re- xation, partial revision, or major revision/ removal of the implant. Not all failures required a second MUTARS because
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