A newly revised pivot knee prosthesis for peri-knee malignant bone destruction tumor management

Abstract BackgroundThis study evaluated the effectiveness of a newly revised pivot knee prosthesis in patients with peri-knee malignant bone destruction tumors.MethodsMedical records of patients who were admitted to our hospital from January 2014 to February 2020 and underwent the newly revised pivot knee prosthesis operations were retrospectively collected and analyzed. Visual analogue scale (VAS), hospital special surgery (HSS) knee score, American knee society knee score (KSS), and ROM for pre-operation, discharge, and last follow-up were applied to assess the effectiveness of this surgery. Meanwhile, the results of musculoskeletal tumor society system (MTSS) and radiographs were observed and analyzed at last follow-up.ResultsThe average operation time was 174.0 ± 35.5 min, and intraoperative bleeding volume was 271.2 ± 127.3 ml. The follow-up time was 33.8 ± 14.9 months. The scores of VAS, HSS, and KSS at pre-operation, discharging, and last follow-up were all comparable (p༜0.05), ROM was only comparable between discharging and last follow-up (p༜0.05), while ROM between preoperative and discharging had no significance (p༞0.05). MTSS at last follow-up was22.6 ± 2.4. All patients were alive with their prosthesis in good condition except for one patient who underwent revision surgery for misalignment of prosthesis and two patients who died of systemic metastasis.ConclusionThe newly revised pivot knee prosthesis is a good alternative limb-salvage strategy for patients who suffered from bone destruction tumors, although patient tumor stage and health condition should be fully assessed before surgery to reduce the mortality rate of patients who are not eligible.