Cases report and literature review of extensor mechanism reconstruction after proximal tibia prosthesis arthroplasty

HUANG Jun-qi; BI Wen-zhi; HAN Gang; JIA Jin-peng; XU Meng; WANG Wei

doi:10.3969/j.issn.2095-252X.2017.03.010

Abstract：Objective To compare the clinical results of different extensor mechanism reconstruction techniques after proximal tibia prosthesis replacement.Methods From January 2012 to January 2014, the patients who received proximal tibia tumor resection, prosthesis replacement and extensor mechanism reconstruction were enrolled. Joint function and complications were assessed after the surgery. Associated manuscripts were searched in PubMed, Springer, Ovid, LWW and EMBASE, with the tibia, neoplasm and arthroplasty as the key words. Relevant articles were included and discussed.Results A total of 32 patients met the requirements, who all received prosthesis replacement. Extensor lag was noticed in 5 patients and infection in 2 patients during the follow-up. Nine articles were in accordance with the criteria, including 362 cases with osteosarcoma, 26 cases with chondrosarcoma, 21 cases with Ewing sarcoma, 21 cases with giant cell tumor of bone and 25 cases with soft tissue sarcoma. There were 272 cases receiving traditional prosthesis replacement, 2 cases receiving autograft replacement and 24 cases receiving biological reconstruction. After the surgery, extensor lag was found in 29 cases, infection in 39 cases, ligament rupture in 24 cases, relapse in 25 cases and prosthesis failure in 133 cases.Conclusions With extensor mechanism reconstruction, joint function can be restored but with a lot of postoperative complications. Through the comparison of different reconstruction techniques, no obvious advantages can be found in a single one. Nowadays, biological reconstruction is gaining more and more attention and can be used to improve the function.