Recently, pre- and/or postoperative chemotherapy has been widely used to achieve better general and local control of high grade bone sarcomas. With neoadjuvant treatment, limb salvage is now performed in about 80% of patients, including those with lesions that require more prologned and extensive resections. The relationship between chemotherapy, both as adjuvant and neoadjuvant treatment, and the incidence of perioperative complications (infection, delayed wound healing, etc.) is not well documented. In a recent report of 304 consecutive resections and reconstructions with different implants of major long bones (Capanna et al. 1989), we noted only a slight difference in perioperative complications between those patients receiving no chemotherapy and those receiving adjuvant chemotherapy. Neoadjuvant chemotherapy, however, seems to increase the incidence and severity of postoperative complications. After neoadjuvant chemotherapy, reconstructions with an uncemented prosthesis led, in our experience, to a lower rate of perioperative complications. The aim of this paper is to analyze the effect of chemotherapy on the evolution of the implant, taking into account other parameters that may also influence bone ingrowth and prosthetic fixation.
The effect of chemoterapy on uncemented prostheic replacement
CAPANNA, RODOLFO;
1991-01-01
Abstract
Recently, pre- and/or postoperative chemotherapy has been widely used to achieve better general and local control of high grade bone sarcomas. With neoadjuvant treatment, limb salvage is now performed in about 80% of patients, including those with lesions that require more prologned and extensive resections. The relationship between chemotherapy, both as adjuvant and neoadjuvant treatment, and the incidence of perioperative complications (infection, delayed wound healing, etc.) is not well documented. In a recent report of 304 consecutive resections and reconstructions with different implants of major long bones (Capanna et al. 1989), we noted only a slight difference in perioperative complications between those patients receiving no chemotherapy and those receiving adjuvant chemotherapy. Neoadjuvant chemotherapy, however, seems to increase the incidence and severity of postoperative complications. After neoadjuvant chemotherapy, reconstructions with an uncemented prosthesis led, in our experience, to a lower rate of perioperative complications. The aim of this paper is to analyze the effect of chemotherapy on the evolution of the implant, taking into account other parameters that may also influence bone ingrowth and prosthetic fixation.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.