INTRODUCTION: The proximal tibia is a common location for bone tumors. Two contemporary reconstruction techniques for limb salvage are endoprosthetic replacement (EPR) and allograft-prosthesis composite (APC). This study aimed to compare the long-term oncologic and functional outcomes of EPR and APC reconstructions. METHODS: Thirty-eight (19 APC and 19 EPR) patients underwent oncologic proximal tibia resection and reconstruction were reviewed. Patients undergoing APC reconstruction were younger than the EPR group (31 vs. 44 years, p = 0.049), and patients in the EPR group were more likely to have a diagnosis of metastatic disease (32% vs. 0%, p = 0.019). RESULTS: For all patients, the 10-year disease-specific survival was 63%. With death a competing risk, there was no difference in the 10-year cumulative risk of failure (41% vs. 26%, p = 0.171) or amputation (11% vs. 19%, p = 0.690) between APC or EPR. There was no difference comparing EPR to APC in the proportion of patients with an extensor lag > 10° (42% vs. 26%, p = 0.495) or 10-year knee society scores (85 vs. 85, p = 0.710). CONCLUSION: EPR and APC have a similar complication profile and functional outcomes following proximal tibial resection and reconstruction.
Ulrich et al. (Wed,) studied this question.