Treatment of Infected Tumor Prosthesis in Malignant Bone Tumor

Cho, Wan Hyeong; Park, Jong Hoon; Song, Won Seok; Lee, Soo Yong; Jeon, Dae Geun; Oh, Jung Moon; Kim, Jin Wook

Abstract

PURPOSE
The analysis points used in this study were the features, durations, and outcomes following different treatment modalities for an infected tumor prosthesis (TP). These were used to define an appropriate strategy for infected TP. MATERIALS AND METHODS: From December 1986 to November 1999, 215 patients underwent a TP replacement operation in our hospital, and 17 patients with an infected TP were eligible for the study. Forty-two operative procedures were performed on 17 patients (scarectomy 11 cases, partial TP removal and bone cementation 9 cases, complete TP removal and bone cementation 20 cases, and amputation 2 cases). Freedom from infection was defined as no sign of inflammation for 3 months after the operation and its objective variables were CRP, ESR, physical examination, and culture free body fluid. Although one patient received several procedures, we considered each event as a separate variable. The survival rates of the procedures were analysed by Kaplan-Meier plots and these were compared using the log rank test. RESULTS: The cumulative survival of each procedure was 0% by scarectomy at 11 months, 0% by partial TP removal and bone cementation at 12 months, and 34% by complete TP removal and bone cementation at 79 months. Significant differences in survival were found for these procedures (p<.001). CONCLUSION: Aggressive initial management reduces patient's pain and increases the chance of returning to the original functional status.