Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Department of Radiology, Miller School of Medicine, University of Miami, Jackson Memorial Hospital, Miami, FL 33136, USA.
Curr Oncol. 2024 Oct 17;31(10):6245-6266. doi: 10.3390/curroncol31100465.
Limb salvage surgeries utilizing endoprostheses and allografts are performed for a variety of oncologic conditions. These reconstructions can fail and require revision for many reasons, which are outlined and classified into mechanical failures (soft tissue failures, aseptic loosening, structural failure), non-mechanical failures (infection, tumor progression), and pediatric failures (physeal arrest, growth dysplasia). Distinct radiologic and clinical findings define specific failure subtypes but are sparsely illustrated in the radiology literature. Specifically, an understanding of the organizational structure of the failure modes can direct radiologists' search for post-reconstruction complications, enhance an appreciation of their prognostic significance, and facilitate research by standardizing the language and conceptual framework around outcomes. The purpose of this review is to highlight the key radiologic findings and imaging studies of each failure mode in orthopedic oncologic reconstructive surgery in the context of risk factors, failure rates, prognosis and survival statistics, and clinical decision-making regarding chemotherapy, radiation, and revision surgery.
利用假体和同种异体移植物进行保肢手术适用于多种肿瘤疾病。这些重建可能会因多种原因而失败，需要进行修复，这些原因被概述并分类为机械故障（软组织失败、无菌性松动、结构失败）、非机械故障（感染、肿瘤进展）和儿科失败（骺板停止、生长发育不良）。不同的放射学和临床发现定义了特定的失败亚型，但在放射学文献中很少有说明。具体来说，对失败模式的组织结构的理解可以指导放射科医生寻找重建后并发症，增强对其预后意义的认识，并通过标准化语言和围绕结果的概念框架来促进研究。本综述的目的是强调在骨科肿瘤重建手术中，每种失败模式的关键放射学发现和影像学研究，并结合风险因素、失败率、预后和生存统计数据以及关于化疗、放疗和修复手术的临床决策进行讨论。
