Distal Tibia Endoprosthesis Reconstruction after Resection of Aggressive Bone Tumors: Is it a Reliable Treatment Option?
Bibliographic record
Abstract
Introduction: Primary bone tumours of the distal tibia are rare, and amputation was the treatment of choice in the past. Custom-made endoprosthesis reconstruction of the distal tibia has become a viable option in selected patients as a form of limb salvage for better function and cosmesis. It provides similar functional outcomes to below-knee amputation with a below-knee prosthesis. We investigated our cases' reliability, functional and oncological outcomes with distal tibia endoprosthesis reconstruction done for aggressive bone tumours. Methods: This is a retrospective review of 10 patients who underwent distal tibia endoprosthesis reconstruction at our centre from December 2007 to December 2021. This study aims to determine the clinical, oncological and functional outcomes using the Musculoskeletal Tumor Society (MSTS) Score and Toronto Extremity Salvage Score (TESS) and the survivorship of these implants. Results: The mean age of our patients is 29 years (range 12 to 53), with 60% males. The mean follow-up was 39.3 months (range 12 to 112). 50% of our cases were giant cell tumour of bone, 20% were osteosarcoma, and 10% were ewing’s, PVNS and pleomorphic sarcoma of the bone, respectively. Two patients passed away from advanced disease, where one was associated with local recurrence. The other case with local recurrence developed an acute infection post-resection of the recurrence. The infection resolved after repeated debridement and free muscle transfer. One patient had septic loosening of the implant and underwent below-knee amputation. Two-thirds of the patients remained disease free. The mean MSTS score for the 9 patients during their last follow-up is 87.8% (range 73.3 to 100). The mean TESS score for the 6 patients during their last follow-up is 84.4% (range 69.2 to 100). Conclusion: Our study concludes that distal tibia endoprosthesis reconstruction is a reliable treatment option for aggressive bone tumours and provides good function outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".