Damron Timothy A, Malhotra Anjali
From the Department of Orthopedic Surgery, SUNY Upstate Medical University (Dr. Damron), and the Norton College of Medicine, SUNY Upstate Medical University (Malhotra).
J Am Acad Orthop Surg Glob Res Rev. 2025 Jul 2;9(7). doi: 10.5435/JAAOSGlobal-D-24-00201. eCollection 2025 Jul 1.
Intercalary endoprosthetic devices are a diaphyseal segmental reconstructive option for both primary tumors and skeletal metastases, most used for pathological fractures or failure of internal fixation. Numerous designs have been employed with varying success. These implants require adequate quality and length bone stock, both proximal and distal, to be employed. Alternative reconstructions may include vascularized fibula autograft, allograft reconstruction, acute shortening, and fixation with cement spacer augmentation with planning staged procedures. The reported functional results and complication profile of intercalary endoprostheses are acceptable, but their use is carefully considered, as aseptic loosening remains one of the most common risks for failure. Although successful at short follow-up, these devices are often used for patients with segmental destruction or tumor involvement of the upper extremity, particularly in cases with metastatic bone disease or myeloma. In this review, we discuss the numerous designs, indications and contraindications, alternative options, biomechanics, reported results, and complications.
节段性内置假体装置是原发性肿瘤和骨转移瘤的骨干节段性重建选择，最常用于病理性骨折或内固定失败。已经采用了许多设计，取得了不同程度的成功。这些植入物需要在近端和远端都有足够质量和长度的骨量才能使用。替代重建方法可能包括带血管腓骨自体移植、同种异体移植重建、急性缩短以及用骨水泥间隔物增强固定并计划分期手术。报道的节段性内置假体的功能结果和并发症情况是可以接受的，但使用时会谨慎考虑，因为无菌性松动仍然是最常见的失败风险之一。尽管在短期随访中取得了成功，但这些装置通常用于上肢节段性破坏或肿瘤累及的患者，特别是在转移性骨病或骨髓瘤的病例中。在本综述中，我们讨论了众多的设计、适应证和禁忌证、替代选择、生物力学、报道的结果以及并发症。
