PMC6011161_01
Preoperative X-ray from a right tibia. A plain X-ray from a right tibia with an intraosseal tumor that extended from 4 cm below the knee joint proximally to about 4 cm from the ankle joint distally.
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A plain X-ray and magnetic resonance image (MRI) confirmed an intraosseal tumor that extended from 4 cm below the knee joint proximally to about 4 cm from the ankle joint distally (Figure 1).
The preoperative planning of a custom-made total tibia endoprosthesis. The preoperative planning for total tibia resection and reconstruction with a custom-made, silver-coated, modular endoprosthesis of the Modular Universal Tumor and Revision System.
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Tumor and Revision System (Implantcast , Buxtehude, Germany) (Figure 2).
Postoperative X-ray from a right tibia. The knee joint was reconstructed with a metal-on-poly articulation with a (unique) metal-on-metal hinge mechanism, and the ankle joint was reconstructed with a metal-on-poly hinge joint with a talar replacement, stabilized with a trans-talar and trans-calcanear hydroxyapatite-coated stem. A supplementary screw was used to add stability in the subtalar joint.
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The knee joint was reconstructed with a metal-on-poly articulation with a (unique) metal-on-metal hinge mechanism (Figure 3). The ankle joint was reconstructed with a metal-on-poly hinge joint with a talar replacement, stabilized with a trans-talar and trans-calcanear hydroxyapatite-coated stem.
Perioperative image of the total tibia resection and reconstruction. The tibia tumor is totally resected, and the tibia is replaced with a custom-made endoprosthesis. The endoprosthesis was enveloped in a Trevira tube to facilitate the attachment of soft tissues and the patella tendon.
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The endoprosthesis was enveloped in a Trevira (Implantcast ) tube to facilitate the attachment of soft tissues and the patella tendon (Figure 4).
Patient's right lower extremity image in an 8-year follow-up visit. The silver coating created a mild, local skin argyria pigmentation, with cosmetic discomfort.
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The silver coating created a mild, local skin argyria pigmentation, with cosmetic discomfort (Figure 5).