Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press180BONE SARCOMASСАРКОМЫ КОСТЕЙEstimation of reconstruction results of the ankle joint with the megaprosthesis for aggressive bone tumors of disral tibiaРезультаты реконструкции голеностопного сустава мегапротезом при поражении опухолью дистального отдела большеберцовой костиAlievM. D.АлиевМ. Д.
Russian Federation
smog2006@mail.ruSokolovskyV. A.СоколовскийВ. А.
Russian Federation
SokolovskyA. V.СоколовскийА. В.
Russian Federation
SergeevP. S.СергеевП. С.
Russian Federation
N.N. Blokhin Russian Cancer Research Center, RussianAcademy of Medical SciencesРоссийский онкологический научный центр им. Н.Н. Блохина РАМН1111201024131911012022Copyright ©; 2010, Aliev M.D., Sokolovsky V.A., Sokolovsky A.V., Sergeev P.S.Copyright ©; 2010, Алиев М.Д., Соколовский В.А., Соколовский А.В., Сергеев П.С.2010Aliev M.D., Sokolovsky V.A., Sokolovsky A.V., Sergeev P.S.Алиев М.Д., Соколовский В.А., Соколовский А.В., Сергеев П.С.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/180

In a current of two years with 2008 for 2010, to six patients with primary malignant and aggressively benign bone tumors of the distal tibia executed six operations, in value of tumor resection with the subsequent reconstruction of defect by an anklejoint endoprosthesis. In group of patients there were five males and one female, with a mean age of 30 years. Among the treated patients 2 were with an osteosarcoma, 2 with Ewing’s sarcoma and 2 with giant cell tumor. The mean duration of followup after the operation was 14,7 months (7 to 28). Reconstruction of the distal tibia defect was carried out using oncological modular endoprosthesis of the ankle joint. Median recurrence free survival during 2,4 years was 83%. Progressing of the primary disease is revealed in 50% in the form of occurrence of the distant metastasis in lungs. A mean functional result assessed with the using of the MSTS system and consisted 75%. During the whole follow up period non of six patients had complications such as periprosthesis infection, instability of a design of endoprosthesis or its fracture. One patient with osteosarcoma half a year after endoprosthesis was installed, revealed a local recurrence during conservative treatment, amputation has been executed. To achieve good clinical and functional results absolute indications for reconstructive operations of an anklejoint should be strictly followed with careful selection of patients according to the results of conservative treatment.

В течение двух лет, с 2008 по 2010 г., шести пациентам с первичными злокачественными и высокоагрессивными доброкачественными новообразованиями дистального отдела большеберцовой кости выполнено шесть операций в объеме резекции опухоли с последующей реконструкцией дефекта эндопротезом голеностопного сустава. В группе пациентов были 5 мужчин и 1 женщина, средний возраст которых составил 30 лет. Среди пролеченных пациентов 2 были с остеосаркомой, 2-е саркомой Юинга, 2-е гигантоклеточной опухолью кости. Средний срок наблюдения после операции составил 14,7 мес (от 7 до 28 мес). Реконструкция дефекта дистального отдела большеберцовой кости осуществлялась с использованием онкологических модульных эндопротезов голеностопного сустава. Общая безрецидивная выживаемость за период 2,4 года составила 83%. Прогрессирование основного заболевания выявлено в 50% в виде появления отдаленных метастазов в легкие. Средний функциональный результат оценивался по системе MSTS и составил 75%.

tumors of distal tibiareconstruction of the ankle jointmegaprosthesisопухоль дистального отдела большеберцовой костиреконструкция голеностопного суставамегапротезТрапезников H.H., Алиев М.Д., Синюков П.А. и соавт. Современные подходы в лечении злокачественных опухолей костей. Мат. юбилейной конф. «Проблемы современнойонкологии». Томск, 1999, с. 309-312.Трапезников H.H., Алиев М.Д., Соловьев Ю.Н. и соавт. Процесс и перспективы развития методов лечения сарком костей. Рос. онкол. журн. 1998, № 3, с. 21-25.Aliev M.D., Nisichenco D.V., Saravanan S.A. et al. Instability of the endoprosthesis in bone tumors. A retrospective analysis. 22th Annual Meeting of the European Musculoskelet al. Oncology Society (EMSOS). 13-16 May, 2009.Aliev M.D., Nisichenco D.V., Saravanan S.A. et al. Using modular endoprosthesis at oncological patient - our expirient. 22th Annual Meeting of the European Musculoskelet al. Oncology Society (EMSOS). 13-16 May, 2009.Sokolovskiy V.A., Nisichenco D.V., Orekhov M.N. et al. Use of megaprotheses at total replacement of the femur at oncological patient. 23th Annual Meeting of the European Musculoskelet al. Oncology Society (EMSOS). 5-7 May, 2010.Shalaby S., Shalaby H., Bassiony A. Limb salvage for osteosarcoma of the distal tibia with resection arthrodesis, autogenous fibular graft and Ilizarov external fixator. J. Bone Joint Surg. [Br.], 2006, 88-B, p. 1642-1646.Casadei R., Ruggieri P., Giuseppe T. et al. Ankle resection arthrodesis in patients with bone tumors. FootAnkle Int. 1994, v. 15, p. 242-249.Lee S.H., Kim H.S., Park Y.B. et al. Prosthetic reconstruction for tumours of the distal tibia and fibula. J. Bone Joint Surg. [Br.] 1999,81-B,p.803-807.Lewis G. Lhe anklejoint prosthetic replacement: clinical performance and research challenges. Foot Ankle Int. 1994, v. 15, p. 471-476. Bibliographic Links.Newton S.E. Lotal ankle arthroplasty: clinical study of fifty cases. J. Bone Joint Surg. [Am.] 1982, 64-A, p. 104-111.Unwin P., Cannon S., Kemp H. et al. The Stanmore distal tibial replacement. In: Limb salvage current trends. Proceedings of the 7th ISOLS Meeting. 1993, p. 562.Zeytoonjian L., Mankin H.J., Gebhardt M.C., Homicek F.J. Distal lower extremity sarcomas: frequency of occurrence and patient survival rate. Foot Ankle Int. 2004, v. 25, p. 325-330.Hoppenfeld S., de Boer P., Buckley R. Surgical exposures in orthopaedics: the anatomic approach. Fourth edition. Philadelphia; Lippincott Williams & Wilkins. 2009, p. 607-675.Ebeid W., Amin S., Abdelmegid A., Refaat Y., Ghoneimu A. Reconstruction of distal tibial defects following resection of malignant tumours by pedicled vascularised fibular grafts. Acta Orthop. Belg. 2007, v. 73, p. 354-359.Laitinen M., Hardes J., Ahrens H. et al. Treatment of primary malignant bone tumours of the distal tibia. Int. Orthop. 2005, v. 29, p. 255-259.Natarajan M.V., Annamalai K., Williams S., Selvaraj R., Rajagopal T.S. Timb salvage in distal tibial osteosarcoma using a custom mega prosthesis. Int. Orthop. 2000, v. 24, p. 282-284.Abudu A., Grimer R.J., Tillman R.M., Carter S.R. Endoprosthetic replacement of the distal tibia and ankle joint for aggressivebone tumours. Int. Orthop. 1999, v. 23, p. 291-294.Myers G.J., Abudu A.T., Carter S.R. et al. The long-term results of endoprosthetic replacement of the proximal tibia for bone tumours. J. Bone Joint Suig. [Br.] 2007, 89-B, p. 1632-1637.Tumors of soft tissue and bones. 2006, p. 149.Wood P.L.R., Prem H., Sutton C. Total ankle replacement: medium-term results in 200 Scandinavian total ankle replacements. J. Bone Joint Surg. [Br.] 2008, 90-B, p. 605-609.Blunn G.W., Briggs T.W.R., Cannon S.R. et al. Cementless fixation for primary segmental bone tumour endoprosthesis. Clin. Orthop. 2000, v. 372, p. 223-230.Fox E.J., Hau M.A., Gebhardt M.C. et al. Long-termfollowup of proximal femoral allografts. Clin. Orthop. 2002, v. 397, p. 106-113.Unwin P.S., Cannon S.R., Grimer R.J. et al. Aseptic loosening in cemented custom-made prosthetic replacements for bone tumours of the lower limb. J. Bone Joint Surg. [Br.]. 1996, 78-B,p.5-13.Jeys L.M., Grimer R.J., Carter S.R., Tillman R.M. Periprosthetic infection in patients treated for an orthopaedic oncological condition. J. Bone Joint Surg. [Am.]. 2005, 87-A, p. 842-849.Bonnin M., Judet T., Colombier J.A. et al. Midterm results of the Salto total ankle prosthesis. Clin. Orthop. 2004, v. 424, p. 6-18.Shekkeiis A.S., Hanna S.A., Sewell M.D. et al. Endoprosthetic reconstruction of the distal tibia and ankle joint after resection of primary bone tumours. J. Bone Joint Surg. [Br.] 2009, 91-B,p. 1378-1382.Hardes J., Ahrens H., Gebert C. et al. Treatment ofprimary malignant bone tumours of the distal tibia. Int. Orthop. 2006, v. 29 (4), p. 255-259, 2005.Ozaki T., Hillman A., Lindner N., Wmkelmann W. Surgical treatment of bone sarcomas of the fibula: analysis of 19 cases. Arch. Orthop. Trauma Surg. 1997, v. 116, p. 475-479.Choong P.F., Sim F.H. Limb-sparing surgery forbone tumors: new developments. Semin Surg. Oncol. 1997, v. 13, p. 64-69.Eckardt J.J., Eilber F.R., Rosen G. et al. Endoprosthetic replacement for stage IIB osteosarcoma. Clin. Orthop. 1991, v. 270, p. 202-213.Simon M.A., Aschiliman M.A., Thomas N., Mankin H.J. Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J. Bone Joint Suig. [Am] 1986, 68-A, p. 1331-1337.Coonoor R. Chandrasekar, Robert J. Grimer, Simon R. Carter, Roger M. Tillman, Seggy T. Abudu, Lee M. Jeys. Malignant Tumours of the Foot and Ankle: Results of Limb Salvage and Amputation. ISOLS. 2009.Carty C., Steadman P., Dickinson I., Sommerville S., Brisbane. Functional following endoprosthetic replacement in patient with lower limb bone sarcoma. ISOLS. 2007.Diaz de Rada P., San Julian M., Duart J., Sierrasesumaga L., Gairaus M. Pamplona. Limb salvage in foot and ankle Ewing's Sarcoma. ISOLS. 2007.Lohmann C., Beil T., Güthoff W., Rüther W.A. New System of Mega-Endoprostheses for Use in Tumor and Revision Surgery. ISOLS. 2007.