Browsing by Author "Hilton, Thomas"

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    Acetabular reconstruction using a ?Cone Cup? prosthesis in a series of 13 patients
    (2023) Klopper, Schalk; Hilton, Thomas
    Background Endoprosthetic reconstruction of major pelvic bone loss in oncology and revision arthroplasty surgery is associated with high complication rates. However, comparative data for reconstructive methods are limited. We present short-term clinical, radiological, and functional outcomes of the implantcast MUTARSâ LUMICâ prosthesisfor acetabular reconstruction after major pelvic bone resection orloss. Methods Retrospective folder review from December 2019 to June 2022. Minimum follow up was 12 months. The inclusion criterion was all patients who underwent acetabular reconstruction with the implantcast MUTARSâ LUMICâ cone cup prosthesis. Results Thirteen patients were included in the study. The indication for pelvic resection was a primary bone tumour in five patients, metastatic bone disease in five and failed arthroplasty in three. Complications included 2 patients with dislocation, 3 with infection, and 1 with both. The overall complication rate was 46%. Median MSTS scores at 12 months assessed in 8 patients was 20.75 of 30 points. Conclusion Our results are in agreement with other series, highlighting the problems of instability and deep infection. Patients without complications had an acceptable functional outcome.
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    Modular prosthetic reconstruction for primary bone tumours of the distal tibia in ten patients
    (2022) Mugla, Walid; Hilton, Thomas
    Introduction: Below knee amputation is the safest treatment for aggressive benign and malignant bone tumours of the distal tibia yielding good oncological and functional results. However, in selected patients where limb salvage is feasible and amputation unacceptable to the patient, limb salvage using a distal tibial replacement (DTR) can be considered. This study aims to present the oncological and functional results of the use of this treatment method in our unit. Patients & Methods: A retrospective folder review was performed for all 10 patients who received a modular distal tibial replacement between 01/01/2005 and 31/01/2019 for a primary bone tumour either benign aggressive or malignant. Six were female and the mean age was 31 (1275) years. There were five patients with giant cell tumour of bone, four with osteosarcoma and one with a low-grade chondrosarcoma. The patients with osteosarcoma had neo-adjuvant chemotherapy before surgery. Function was assessed by the Musculoskeletal Tumor Society (MSTS) score. Results: There were six females and four males, with a mean age of 31 (12-75) years. Two patients had local recurrence treated with a BKA and one other patient died of metastases three years postoperatively. At a mean follow-up of three years, the remaining eight patients had a mean MSTS score of 83% (67–93%). There were no radiological signs of loosening, and no revision surgeries. Conclusion: Endoprosthetic replacement of the distal tibia for primary bone tumours can be a safe treatment option in very selected cases.