A dual-center review of compressive osseointegration for fixation of massive endoprosthetics: 2- to 9-year followup

George T. Calvert, Judd E. Cummings, Austin J. Bowles, Kevin B. Jones, L. Daniel Wurtz, R Randall

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Aseptic failure of massive endoprostheses used in the reconstruction of major skeletal defects remains a major clinical problem. Fixation using compressive osseointegration was developed as an alternative to cemented and traditional press-fit fixation in an effort to decrease aseptic failure rates. Questions/purposes: The purpose of this study was to answer the following questions: (1) What is the survivorship of this technique at minimum 2-year followup? (2) Were patient demographic variables (age, sex) or anatomic location associated with implant failure? (3) Were there any prosthesis-related variables (eg, spindle size) associated with failure? (4) Was there a discernible learning curve associated with the use of the new device as defined by a difference in failure rate early in the series versus later on? Methods: The first 50 cases using compressive osseointegration fixation from two tertiary referral centers were retrospectively studied. Rates of component removal for any reason and for aseptic failure were calculated. Demographic, surgical, and oncologic factors were analyzed using regression analysis to assess for association with implant failure. Minimum followup was 2 years with a mean of 66 months. Median age at the time of surgery was 14.5 years. Results: A total of 15 (30%) implants were removed for any reason. Of these revisions, seven (14%) were the result of aseptic failure. Five of the seven aseptic failures occurred at less than 1 year (average, 8.3 months), and none occurred beyond 17 months. With the limited numbers available, no demographic, surgical, or prosthesis-related factors correlated with failure. Conclusions: Most aseptic failures of compressive osseointegration occurred early. Longer followup is needed to determine if this technique is superior to other forms of fixation.

Original languageEnglish (US)
Pages (from-to)822-829
Number of pages8
JournalClinical Orthopaedics and Related Research
Volume472
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Osseointegration
Demography
Prostheses and Implants
Learning Curve
Tertiary Care Centers
Survival Rate
Regression Analysis
Equipment and Supplies

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

A dual-center review of compressive osseointegration for fixation of massive endoprosthetics : 2- to 9-year followup. / Calvert, George T.; Cummings, Judd E.; Bowles, Austin J.; Jones, Kevin B.; Wurtz, L. Daniel; Randall, R.

In: Clinical Orthopaedics and Related Research, Vol. 472, No. 3, 01.01.2014, p. 822-829.

Research output: Contribution to journalArticle

Calvert, George T. ; Cummings, Judd E. ; Bowles, Austin J. ; Jones, Kevin B. ; Wurtz, L. Daniel ; Randall, R. / A dual-center review of compressive osseointegration for fixation of massive endoprosthetics : 2- to 9-year followup. In: Clinical Orthopaedics and Related Research. 2014 ; Vol. 472, No. 3. pp. 822-829.
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abstract = "Background: Aseptic failure of massive endoprostheses used in the reconstruction of major skeletal defects remains a major clinical problem. Fixation using compressive osseointegration was developed as an alternative to cemented and traditional press-fit fixation in an effort to decrease aseptic failure rates. Questions/purposes: The purpose of this study was to answer the following questions: (1) What is the survivorship of this technique at minimum 2-year followup? (2) Were patient demographic variables (age, sex) or anatomic location associated with implant failure? (3) Were there any prosthesis-related variables (eg, spindle size) associated with failure? (4) Was there a discernible learning curve associated with the use of the new device as defined by a difference in failure rate early in the series versus later on? Methods: The first 50 cases using compressive osseointegration fixation from two tertiary referral centers were retrospectively studied. Rates of component removal for any reason and for aseptic failure were calculated. Demographic, surgical, and oncologic factors were analyzed using regression analysis to assess for association with implant failure. Minimum followup was 2 years with a mean of 66 months. Median age at the time of surgery was 14.5 years. Results: A total of 15 (30{\%}) implants were removed for any reason. Of these revisions, seven (14{\%}) were the result of aseptic failure. Five of the seven aseptic failures occurred at less than 1 year (average, 8.3 months), and none occurred beyond 17 months. With the limited numbers available, no demographic, surgical, or prosthesis-related factors correlated with failure. Conclusions: Most aseptic failures of compressive osseointegration occurred early. Longer followup is needed to determine if this technique is superior to other forms of fixation.",
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