Öztürk R. Expandable endoprostheses in skeletally immature patients: Where we are. World J Orthop 2024; 15(4): 312-317 [PMID: 38680670 DOI: 10.5312/wjo.v15.i4.312]
Corresponding Author of This Article
Recep Öztürk, MD, Associate Professor, Researcher, Surgeon, Surgical Oncologist, Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Hufelandstraße 55, Essen 45143, Germany. ozturk_recep@windowslive.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Apr 18, 2024; 15(4): 312-317 Published online Apr 18, 2024. doi: 10.5312/wjo.v15.i4.312
Expandable endoprostheses in skeletally immature patients: Where we are
Recep Öztürk
Recep Öztürk, Tumororthopädie und Sarkomchirurgie, Universitätsklinikum Essen, Essen 45143, Germany
Author contributions: Öztürk R, designed the study; performed the research; analyzed the data and wrote the manuscript.
Conflict-of-interest statement: The author stated that there is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: November 3, 2023 Peer-review started: November 3, 2023 First decision: January 12, 2024 Revised: January 26, 2024 Accepted: March 15, 2024 Article in press: March 15, 2024 Published online: April 18, 2024 Processing time: 164 Days and 11.1 Hours
Abstract
Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality. Until the early 1990s, the treatment options for these patients were rotationplasty or amputation. Multimodal approaches that combine imaging, chemotherapy, and surgical techniques have enabled the development of limb-preserving methods with satisfactory results. In order to overcome inequality problems, expandable prostheses have been developed in the 1980s. Extendable endoprosthesis replacements have been improved over the years and are now an established and safe alternative. Noninvasive prostheses appear to be advantageous compared to minimally invasive expandable prostheses that require multiple surgical procedures, but the complication rate remains high. Therefore, although expandable prostheses are not the definitive answer to the treatment of bone sarcomas in skeletally immature children, they are still a suitable interim choice until full adulthood is achieved. Due to reported high complication rates, the procedures require significant experience and are recommended for use only in specialized cancer centers.
Core Tip: Extendable endoprosthesis replacements have been improved over the years and are now an established and safe alternative. Noninvasive prostheses appear to be advantageous compared to minimally invasive expandable prostheses that require multiple surgical procedures, but the complication rate remains high. Due to reported high complication rates, the procedures require significant experience and are recommended for use only in specialized cancer centers.
