Tumor endoprosthetics in the lower limb including expandable prostheses in adolescents up to 16 years: Results and indications

Abstract

Background: Tumor endoprostheses are now implanted with good long-term results in children and adolescents with malignant bone tumors and usually allow long-term limb preservation. Three-dimensional (3D)-printed custom-made implants are increasingly used. Objectives: The purpose of this article is to provide an overview of childhood and adolescent bone tumors and their surgical treatment. The focus of this article is on the lower extremity due to the increased incidence of childhood and adolescent bone tumors in the lower extremity. Methods: The results of a systematic literature search of PubMed and our center’s internal experience are presented. Results and conclusion: Bone tumors in children and adolescents are most frequently found around the knee joint. The therapy of choice is, nowadays, the use of modular tumor prostheses, which are associated with long-term limb preservation in the majority of individuals. Expandable prostheses are used in younger growing children to counteract a large difference in limb length. 3D-printed custom-made implants are increasingly used. In general, tumor prostheses are associated with a higher complication rate compared to primary endoprostheses. Complications and subsequent revision procedures in long-term follow-up include periprosthetic infections, prosthesis wear and aseptic loosening.