Advances in tumour endoprostheses: a systematic review

Overview

This 2019 systematic review in EFORT Open Reviews by Smolle, Andreou, Tunn and Leithner summarises recent literature on tumour endoprostheses. These implants have made limb-salvage surgery possible for many patients with primary bone and soft tissue sarcomas and are increasingly used for symptomatic metastases of the long bones.

Who it is for

Orthopaedic oncologists, orthopaedic surgeons with an interest in reconstruction, musculoskeletal tumour boards and trainees in bone tumour surgery.

Key areas covered

The authors searched PubMed for original articles published in high-ranking orthopaedic and multidisciplinary journals over a recent three-year period and grouped the included studies by anatomical region. These cover endoprostheses of the shoulder girdle, proximal femur, knee region and pelvis, expandable prostheses in children, and the long-term results of tumour endoprostheses. Across these areas, the review considers functional outcome, complications and implant survival.

Notable emphasis

The review notes that the topics of recent research largely matched the priority questions set at an international consensus meeting, with implant survival the most frequently studied outcome. Deep infection emerged as a recurring complication across studies, and the authors recommend that future research concentrate on ways to prevent it in endoprosthetic tumour reconstruction.

How to use this guideline

The article is a map of recent evidence rather than a treatment protocol. Readers should consult the full text for study-level findings by anatomical site.