Skip to main content
Top
Published in: International Orthopaedics 10/2015

01-10-2015 | Review Article

Fractures in bone tumour prosthesis

Authors: Andrea Piccioli, Barbara Rossi, Federico Maria Sacchetti, Maria Silvia Spinelli, Alberto Di Martino

Published in: International Orthopaedics | Issue 10/2015

Login to get access

Abstract

Purpose

The aim of the present narrative review is to report the different aspects related to the fractures around tumour prosthetic implants in terms of technical and medical issues.

Methods

A non systematic literature review on the topic was performed.

Results

Given the increased rate of limb salvage procedures and megaprostheses implanted for bone tumours, the increased number of osteoporotic periprosthetic fractures, and the burden of revision arthroplasty, the number of surgeries using endoprosthetic implants is likely to increase in the near future. Surgeons will face more frequently the complications related to tumour endoprosthetic implant. Endoprosthetic reconstruction has a higher risk of intra-operative and post-operative complications compared to conventional prosthetic replacement.

Conclusions

Very rare reports and recommendations are available in literature regarding the treatment of periprosthetic fractures after megaprosthesis, and there is currently no consensus about which should be the standard management for periprosthetic fractures in this population of patients.
Literature
1.
go back to reference Gebhart M, Shumelinsky F (2012) Management of periprosthetic fractures in patients treated with a megaprosthesis for malignant bone tumours around the knee. Acta Orthop Belg 78:558–563PubMed Gebhart M, Shumelinsky F (2012) Management of periprosthetic fractures in patients treated with a megaprosthesis for malignant bone tumours around the knee. Acta Orthop Belg 78:558–563PubMed
2.
go back to reference Piccioli A, Maccauro G, Scaramuzzo L, Graci C, Spinelli MS (2013) Surgical treatment of impending and pathological fractures of tibia. Injury 44:1092–1096CrossRefPubMed Piccioli A, Maccauro G, Scaramuzzo L, Graci C, Spinelli MS (2013) Surgical treatment of impending and pathological fractures of tibia. Injury 44:1092–1096CrossRefPubMed
3.
go back to reference Piccioli A, Spinelli MS, Maccauro G (2014) Impending fracture: A difficult diagnosis. Injury 45(Suppl 6):S138–S141CrossRefPubMed Piccioli A, Spinelli MS, Maccauro G (2014) Impending fracture: A difficult diagnosis. Injury 45(Suppl 6):S138–S141CrossRefPubMed
4.
go back to reference Clement ND, MacDonald D, Moran M, Burnett R, Howie CR, Patton JT (2015) Mega prosthetic distal femoral arthroplasty for non-tumour indications: Does the indication affect the functional outcome and survivorship? Knee Surg Sports Traumatol Arthrosc 23:1330–1336CrossRefPubMed Clement ND, MacDonald D, Moran M, Burnett R, Howie CR, Patton JT (2015) Mega prosthetic distal femoral arthroplasty for non-tumour indications: Does the indication affect the functional outcome and survivorship? Knee Surg Sports Traumatol Arthrosc 23:1330–1336CrossRefPubMed
5.
go back to reference Berend KR, Lombardi AV Jr (2009) Distal femoral replacement in non tumor cases with severe bone loss and instability. Clin Orthop Relat Res 467:485–492PubMedCentralCrossRefPubMed Berend KR, Lombardi AV Jr (2009) Distal femoral replacement in non tumor cases with severe bone loss and instability. Clin Orthop Relat Res 467:485–492PubMedCentralCrossRefPubMed
6.
go back to reference Kostuj T, Streit R, Baums MH, Schaper K, Meurer A (2015) Midterm Outcome after Mega-Prosthesis Implanted in Patients with Bony Defects in Cases of Revision Compared to Patients with Malignant Tumors. J Arthroplasty. doi:10.1016/j.arth.2015.04.002 PubMed Kostuj T, Streit R, Baums MH, Schaper K, Meurer A (2015) Midterm Outcome after Mega-Prosthesis Implanted in Patients with Bony Defects in Cases of Revision Compared to Patients with Malignant Tumors. J Arthroplasty. doi:10.​1016/​j.​arth.​2015.​04.​002 PubMed
7.
go back to reference Grimer RJ, Carter SR, Tillman RM, Sneath RS, Walker PS, Unwin PS, Shewell PC (1999) Endoprosthetic replacement of the proximal tibia. J Bone Joint Surg (Br) 81:488–494CrossRef Grimer RJ, Carter SR, Tillman RM, Sneath RS, Walker PS, Unwin PS, Shewell PC (1999) Endoprosthetic replacement of the proximal tibia. J Bone Joint Surg (Br) 81:488–494CrossRef
8.
go back to reference Plötz W, Rechl H, Burgkart R, Messmer C, Schelter R, Hipp E, Gradinger R (2002) Limb salvage with tumor endoprostheses for malignant tumors of the knee. Clin Orthop Relat Res 405:207–215CrossRefPubMed Plötz W, Rechl H, Burgkart R, Messmer C, Schelter R, Hipp E, Gradinger R (2002) Limb salvage with tumor endoprostheses for malignant tumors of the knee. Clin Orthop Relat Res 405:207–215CrossRefPubMed
9.
go back to reference Hardes J, Gebert C, Schwappach A, Ahrens H, Streitburger A, Winkelmann W, Gosheger G (2006) Characteristics and outcome of infections associated with tumor endoprostheses. Arch Orthop Trauma Surg 126:289–296CrossRefPubMed Hardes J, Gebert C, Schwappach A, Ahrens H, Streitburger A, Winkelmann W, Gosheger G (2006) Characteristics and outcome of infections associated with tumor endoprostheses. Arch Orthop Trauma Surg 126:289–296CrossRefPubMed
10.
go back to reference Gosheger G, Gebert C, Ahrens H, Streitbuerger A, Winkelmann W, Hardes J (2006) Endoprosthetic reconstruction in 250 patients with sarcoma. Clin Orthop Relat Res 450:164–171CrossRefPubMed Gosheger G, Gebert C, Ahrens H, Streitbuerger A, Winkelmann W, Hardes J (2006) Endoprosthetic reconstruction in 250 patients with sarcoma. Clin Orthop Relat Res 450:164–171CrossRefPubMed
11.
go back to reference Mittermayer F, Krepler P, Dominkus M, Schwameis E, Sluga M, Heinzl H, Kotz R (2001) Long-term followup of uncemented tumor endoprostheses for the lower extremity. Clin Orthop Relat Res 388:167–177CrossRefPubMed Mittermayer F, Krepler P, Dominkus M, Schwameis E, Sluga M, Heinzl H, Kotz R (2001) Long-term followup of uncemented tumor endoprostheses for the lower extremity. Clin Orthop Relat Res 388:167–177CrossRefPubMed
12.
go back to reference Clarke HD, Berry DJ, Sim FH (1998) Salvage of failed femoral megaprostheses with allograft prosthesis composites. Clin Orthop Relat Res 356:222–229CrossRefPubMed Clarke HD, Berry DJ, Sim FH (1998) Salvage of failed femoral megaprostheses with allograft prosthesis composites. Clin Orthop Relat Res 356:222–229CrossRefPubMed
13.
go back to reference Mavrogenis AF, Ruggieri P, Mercuri M, Papagelopoulos PJ (2008) Megaprosthetic reconstruction for malignant bone tumors: complications and outcomes. J Long-Term Eff Med Implants 18:239–251CrossRefPubMed Mavrogenis AF, Ruggieri P, Mercuri M, Papagelopoulos PJ (2008) Megaprosthetic reconstruction for malignant bone tumors: complications and outcomes. J Long-Term Eff Med Implants 18:239–251CrossRefPubMed
14.
go back to reference Sewell MD, Hanna SA, McGrath A, Aston WJ, Blunn GW, Pollock RC, Skinner JA, Cannon SR, Briggs TW (2011) Intercalary diaphyseal endoprosthetic reconstruction for malignant tibial bone tumours. J Bone Joint Surg (Br) 93:1111–1117CrossRef Sewell MD, Hanna SA, McGrath A, Aston WJ, Blunn GW, Pollock RC, Skinner JA, Cannon SR, Briggs TW (2011) Intercalary diaphyseal endoprosthetic reconstruction for malignant tibial bone tumours. J Bone Joint Surg (Br) 93:1111–1117CrossRef
15.
go back to reference Healey JH, Morris CD, Athanasian EA, Boland PJ (2013) Compress knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure. Clin Orthop Relat Res 471:774–783PubMedCentralCrossRefPubMed Healey JH, Morris CD, Athanasian EA, Boland PJ (2013) Compress knee arthroplasty has 80% 10-year survivorship and novel forms of bone failure. Clin Orthop Relat Res 471:774–783PubMedCentralCrossRefPubMed
16.
go back to reference Ahlmann ER, Menendez LR, Kermani C, Gotha H (2006) Survivorship and clinical outcome of modular endoprosthetic reconstruction for neoplastic disease of the lower limb. J Bone Joint Surg 88B:790–795CrossRef Ahlmann ER, Menendez LR, Kermani C, Gotha H (2006) Survivorship and clinical outcome of modular endoprosthetic reconstruction for neoplastic disease of the lower limb. J Bone Joint Surg 88B:790–795CrossRef
17.
go back to reference Kinkel S, Lehner B, Kleinhans JA, Jakubowitz E, Ewerbeck V, Heisel C (2010) Medium to long term results after reconstruction of bone defects at the knee with tumor endoprostheses. J Surg Oncol 101:166–169PubMed Kinkel S, Lehner B, Kleinhans JA, Jakubowitz E, Ewerbeck V, Heisel C (2010) Medium to long term results after reconstruction of bone defects at the knee with tumor endoprostheses. J Surg Oncol 101:166–169PubMed
18.
go back to reference Sim IW, Tse LF, Ek ET, Powell GJ, Choong PF (2007) Salvaging the limb salvage: management of complications following endoprosthetic reconstruction for tumours around the knee. Eur J Surg Oncol 33:796–802CrossRefPubMed Sim IW, Tse LF, Ek ET, Powell GJ, Choong PF (2007) Salvaging the limb salvage: management of complications following endoprosthetic reconstruction for tumours around the knee. Eur J Surg Oncol 33:796–802CrossRefPubMed
19.
go back to reference Capanna R, Scoccianti G, Frenos F, Vilardi A, Beltrami G, Campanacci DA (2015) What was the survival of megaprostheses in lower limb reconstructions after tumor resections? Clin Orthop Relat Res 473:820–830CrossRefPubMed Capanna R, Scoccianti G, Frenos F, Vilardi A, Beltrami G, Campanacci DA (2015) What was the survival of megaprostheses in lower limb reconstructions after tumor resections? Clin Orthop Relat Res 473:820–830CrossRefPubMed
20.
go back to reference Davis AM, Bell RS, Badley EM, Yoshida K, Williams JI (1999) Evaluating functional outcome in patients with lower extremity sarcoma. Clin Orthop Relat Res 358:90–100CrossRefPubMed Davis AM, Bell RS, Badley EM, Yoshida K, Williams JI (1999) Evaluating functional outcome in patients with lower extremity sarcoma. Clin Orthop Relat Res 358:90–100CrossRefPubMed
21.
go back to reference Avedian RS, Goldsby RE, Kramer MJ, O’Donnell RJ (2007) Effect of chemotherapy on initial compressive osseointegration of tumor endoprostheses. Clin Orthop Relat Res 459:48–53CrossRefPubMed Avedian RS, Goldsby RE, Kramer MJ, O’Donnell RJ (2007) Effect of chemotherapy on initial compressive osseointegration of tumor endoprostheses. Clin Orthop Relat Res 459:48–53CrossRefPubMed
22.
go back to reference Graci C, Maccauro G, Muratori F, Spinelli MS, Rosa MA, Fabbriciani C (2010) Infection following bone tumor resection and reconstruction with tumoral prostheses: a literature review. Int J Immunopathol Pharmacol 23:1005–1013PubMed Graci C, Maccauro G, Muratori F, Spinelli MS, Rosa MA, Fabbriciani C (2010) Infection following bone tumor resection and reconstruction with tumoral prostheses: a literature review. Int J Immunopathol Pharmacol 23:1005–1013PubMed
23.
go back to reference Rayan F, Dodd M, Haddad FS (2008) European validation of the Vancouver classification of periprosthetic proximal femoral fractures. J Bone Joint Surg (Br) 90:1576–1579CrossRef Rayan F, Dodd M, Haddad FS (2008) European validation of the Vancouver classification of periprosthetic proximal femoral fractures. J Bone Joint Surg (Br) 90:1576–1579CrossRef
24.
go back to reference Rorabeck CH, Taylor JW (1999) Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin North Am 30:209–214CrossRefPubMed Rorabeck CH, Taylor JW (1999) Classification of periprosthetic fractures complicating total knee arthroplasty. Orthop Clin North Am 30:209–214CrossRefPubMed
25.
go back to reference Piccioli A, Spinelli MS, Forsberg JA, Wedin R, Healey JH, Ippolito V, Daolio PA, Ruggieri P, Maccauro G, Gasbarrini A, Biagini R, Piana R, Fazioli F, Luzzati A, Di Martino A, Nicolosi F, Camnasio F, Rosa MA, Campanacci DA, Denaro V, Capanna R (2015) How do we estimate survival? External validation of a tool for survival estimation in patients with metastatic bone disease-decision analysis and comparison of three international patient populations. BMC Cancer 15:424PubMedCentralCrossRefPubMed Piccioli A, Spinelli MS, Forsberg JA, Wedin R, Healey JH, Ippolito V, Daolio PA, Ruggieri P, Maccauro G, Gasbarrini A, Biagini R, Piana R, Fazioli F, Luzzati A, Di Martino A, Nicolosi F, Camnasio F, Rosa MA, Campanacci DA, Denaro V, Capanna R (2015) How do we estimate survival? External validation of a tool for survival estimation in patients with metastatic bone disease-decision analysis and comparison of three international patient populations. BMC Cancer 15:424PubMedCentralCrossRefPubMed
26.
go back to reference Wright TW, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77:1340–1346PubMed Wright TW, Cofield RH (1995) Humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 77:1340–1346PubMed
27.
go back to reference Worland RL, Kim DY, Arredondo J (1999) Periprosthetic humeral fractures: management and classification. J Shoulder Elbow Surg 8:590–594CrossRefPubMed Worland RL, Kim DY, Arredondo J (1999) Periprosthetic humeral fractures: management and classification. J Shoulder Elbow Surg 8:590–594CrossRefPubMed
28.
go back to reference Henderson ER, Groundland JS, Pala E, Dennis JA, Wooten R, Cheong D, Windhager R, Kotz RI, Mercuri M, Funovics PT, Hornicek FJ, Temple HT, Ruggieri P, Letson GD (2011) Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review. J Bone Joint Surg Am 93:418–429CrossRefPubMed Henderson ER, Groundland JS, Pala E, Dennis JA, Wooten R, Cheong D, Windhager R, Kotz RI, Mercuri M, Funovics PT, Hornicek FJ, Temple HT, Ruggieri P, Letson GD (2011) Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review. J Bone Joint Surg Am 93:418–429CrossRefPubMed
29.
go back to reference Wedin R, Bauer HC (2005) Surgical treatment of skeletal metastatic lesions of the proximal femur: endoprosthesis or reconstruction nail? J Bone Joint Surg (Br) 87:1653–1657CrossRef Wedin R, Bauer HC (2005) Surgical treatment of skeletal metastatic lesions of the proximal femur: endoprosthesis or reconstruction nail? J Bone Joint Surg (Br) 87:1653–1657CrossRef
30.
go back to reference Davidson D, Pike J, Garbuz D, Duncan CP, Masri BA (2008) Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg Am 90:2000–2012CrossRefPubMed Davidson D, Pike J, Garbuz D, Duncan CP, Masri BA (2008) Intraoperative periprosthetic fractures during total hip arthroplasty. Evaluation and management. J Bone Joint Surg Am 90:2000–2012CrossRefPubMed
31.
go back to reference Palumbo BT, Henderson ER, Groundland JS, Cheong D, Pala E, Letson GD, Ruggieri P (2011) Advances in segmental endoprosthetic reconstruction for extremity tumors : a review of contemporary designs and techniques. Cancer Control 18:160–170PubMed Palumbo BT, Henderson ER, Groundland JS, Cheong D, Pala E, Letson GD, Ruggieri P (2011) Advances in segmental endoprosthetic reconstruction for extremity tumors : a review of contemporary designs and techniques. Cancer Control 18:160–170PubMed
32.
go back to reference Weiss RJ, Ekström W, Hansen BH, Keller J, Laitinen M, Trovik C, Zaikova O, Wedin R (2013) Pathological subtrochanteric fractures in 194 patients: a comparison of outcome after surgical treatment of pathological and non-pathological fractures. J Surg Oncol 107:498–504CrossRefPubMed Weiss RJ, Ekström W, Hansen BH, Keller J, Laitinen M, Trovik C, Zaikova O, Wedin R (2013) Pathological subtrochanteric fractures in 194 patients: a comparison of outcome after surgical treatment of pathological and non-pathological fractures. J Surg Oncol 107:498–504CrossRefPubMed
33.
go back to reference Tyler WK, Healey JH, Morris CD, Boland PJ, O'Donnell RJ (2009) Compress periprosthetic fractures: interface stability and ease of revision. Clin Orthop Relat Res 467:2800–2806PubMedCentralCrossRefPubMed Tyler WK, Healey JH, Morris CD, Boland PJ, O'Donnell RJ (2009) Compress periprosthetic fractures: interface stability and ease of revision. Clin Orthop Relat Res 467:2800–2806PubMedCentralCrossRefPubMed
34.
go back to reference Teunis T, Nota SP, Hornicek FJ, Schwab JH, Lozano-Calderón SA (2014) Outcome after reconstruction of the proximal humerus for tumor resection: a systematic review. Clin Orthop Relat Res 472:2245–2253PubMedCentralCrossRefPubMed Teunis T, Nota SP, Hornicek FJ, Schwab JH, Lozano-Calderón SA (2014) Outcome after reconstruction of the proximal humerus for tumor resection: a systematic review. Clin Orthop Relat Res 472:2245–2253PubMedCentralCrossRefPubMed
35.
go back to reference Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW (1996) Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res 324:86–97CrossRefPubMed Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW (1996) Long-term results of allograft replacement in the management of bone tumors. Clin Orthop Relat Res 324:86–97CrossRefPubMed
36.
go back to reference Thompson RC Jr, Pickvance EA, Garry D (1993) Fractures in large-segment allografts. J Bone Joint Surg Am 75:1663–1673PubMed Thompson RC Jr, Pickvance EA, Garry D (1993) Fractures in large-segment allografts. J Bone Joint Surg Am 75:1663–1673PubMed
37.
go back to reference McDonough EB, Crosby LA (2005) Periprosthetic fractures of the humerus. Am J Orthop (Belle Mead NJ) 34:586–591 McDonough EB, Crosby LA (2005) Periprosthetic fractures of the humerus. Am J Orthop (Belle Mead NJ) 34:586–591
38.
go back to reference Williams GR Jr, Iannotti JP (2002) Management of periprosthetic fractures: the shoulder. J Arthroplasty 17(4 Suppl 1):14–16CrossRefPubMed Williams GR Jr, Iannotti JP (2002) Management of periprosthetic fractures: the shoulder. J Arthroplasty 17(4 Suppl 1):14–16CrossRefPubMed
39.
go back to reference Manfrini M, Tiwari A, Ham J, Colangeli M, Mercuri M (2011) Evolution of surgical treatment for sarcomas of proximal humerus in children: retrospective review at a single institute over 30 years. J Pediatr Orthop 31:56–64CrossRefPubMed Manfrini M, Tiwari A, Ham J, Colangeli M, Mercuri M (2011) Evolution of surgical treatment for sarcomas of proximal humerus in children: retrospective review at a single institute over 30 years. J Pediatr Orthop 31:56–64CrossRefPubMed
40.
go back to reference van de Sande MA, Dijkstra PD, Taminiau AH (2011) Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop 35:1375–1380PubMedCentralCrossRefPubMed van de Sande MA, Dijkstra PD, Taminiau AH (2011) Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop 35:1375–1380PubMedCentralCrossRefPubMed
41.
go back to reference Boyd AD Jr, Thornhill TS, Barnes CL (1992) Fractures adjacent to humeral prostheses. J Bone Joint Surg Am 74:1498–1504PubMed Boyd AD Jr, Thornhill TS, Barnes CL (1992) Fractures adjacent to humeral prostheses. J Bone Joint Surg Am 74:1498–1504PubMed
42.
go back to reference Campbell JT, Moore RS, Iannotti JP, Norris TR, Williams GR (1998) Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Shoulder Elbow Surg 7406–7413 Campbell JT, Moore RS, Iannotti JP, Norris TR, Williams GR (1998) Periprosthetic humeral fractures: mechanisms of fracture and treatment options. J Shoulder Elbow Surg 7406–7413
43.
go back to reference Kumar S, Sperling JW, Haidukewych GH, Cofield RH (2004) Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 86A:680–689 Kumar S, Sperling JW, Haidukewych GH, Cofield RH (2004) Periprosthetic humeral fractures after shoulder arthroplasty. J Bone Joint Surg Am 86A:680–689
44.
go back to reference Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Molé D (2002) Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elbow Surg 11:401–412CrossRefPubMed Boileau P, Krishnan SG, Tinsi L, Walch G, Coste JS, Molé D (2002) Tuberosity malposition and migration: reasons for poor outcomes after hemiarthroplasty for displaced fractures of the proximal humerus. J Shoulder Elbow Surg 11:401–412CrossRefPubMed
45.
go back to reference Frankle MA, Greenwald DP, Markee BA, Ondrovic LE, Lee WE 3rd (2001) Biomechanical effects of malposition of tuberosity fragments on the humeral prosthetic reconstruction for four-part proximal humerus fractures. J Shoulder Elbow Surg 10:321–326CrossRefPubMed Frankle MA, Greenwald DP, Markee BA, Ondrovic LE, Lee WE 3rd (2001) Biomechanical effects of malposition of tuberosity fragments on the humeral prosthetic reconstruction for four-part proximal humerus fractures. J Shoulder Elbow Surg 10:321–326CrossRefPubMed
46.
go back to reference Greiner SH, Diederichs G, Kröning I, Scheibel M, Perka C (2009) Tuberosity position correlates with fatty infiltration of the rotator cuff after hemiarthroplasty for proximal humeral fractures. J Shoulder Elbow Surg 18:431–436CrossRefPubMed Greiner SH, Diederichs G, Kröning I, Scheibel M, Perka C (2009) Tuberosity position correlates with fatty infiltration of the rotator cuff after hemiarthroplasty for proximal humeral fractures. J Shoulder Elbow Surg 18:431–436CrossRefPubMed
47.
go back to reference Angelini A, Henderson E, Trovarelli G, Ruggieri P (2013) Is there a role for knee arthrodesis with modular endoprostheses for tumor and revision of failed endoprostheses? Clin Orthop Relat Res 471:3326–3335PubMedCentralCrossRefPubMed Angelini A, Henderson E, Trovarelli G, Ruggieri P (2013) Is there a role for knee arthrodesis with modular endoprostheses for tumor and revision of failed endoprostheses? Clin Orthop Relat Res 471:3326–3335PubMedCentralCrossRefPubMed
48.
go back to reference Hardes J, von Eiff C, Streitbuerger A, Balke M, Budny T, Henrichs MP, Hauschild G, Ahrens H (2010) Reduction of periprosthetic infection with silver-coated megaprostheses in patients with bone sarcoma. J Surg Oncol 101:389–395PubMed Hardes J, von Eiff C, Streitbuerger A, Balke M, Budny T, Henrichs MP, Hauschild G, Ahrens H (2010) Reduction of periprosthetic infection with silver-coated megaprostheses in patients with bone sarcoma. J Surg Oncol 101:389–395PubMed
Metadata
Title
Fractures in bone tumour prosthesis
Authors
Andrea Piccioli
Barbara Rossi
Federico Maria Sacchetti
Maria Silvia Spinelli
Alberto Di Martino
Publication date
01-10-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 10/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2956-7

Other articles of this Issue 10/2015

International Orthopaedics 10/2015 Go to the issue