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Fig 1.

Flow chart of all patients with infection following a primary replacement of a musculoskeletal tumour of the lower limb and reconstruction by a megaprosthesis.

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Table 1.

Demographic data of 83 patients with infected megaprostheses.

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Table 2.

Reinfection rate of the different op procedure: The total number of patients (N), the number of reinfections (n), the reinfection rate (%), and the lower and upper bounds of the 95% confidence interval (95% CI) for the reinfection rate separately for each op procedure.

2-stage revision = patients with and without complete removal of the well fixed stems for the first revision surgery.

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Fig 2.

The cumulative incidence of reinfection (continuous line) and death (dashed line) after one-stage revision.

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Fig 2 Expand

Fig 3.

The cumulative incidence of reinfection (continuous line) and death (dashed line) after two-stage revision (n = 16; patients with and without complete removal of well-fixed stems).

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Table 3.

The reinfection rate (RR) depending on the localisations of the megaprostheses and OP procedures.

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Table 4.

Cause-specific hazard ratios (HR) and 95% confidence intervals (95% CI) for reinfection from patients after 1-stage and 2-stage (with and without well fixed stems for the first revision surgery) revisions in accordance with different factors.

OSA = osteosarcoma, dist = distal, prox = proximal, KMFTR = Kotz Modular Femur and Tibia Reconstruction System, HMRS = Howmedica Modular Reconstruction System, GMRS = Global Modular Reconstruction System, CHT = chemotherapy, RTX = radiotherapy, Infection classification by Coventry and Fitzgerald [13, 14].

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Table 5.

Outcome of the 38 patients with reinfection. In this cohort, seven patients died for a reason not related to infection.

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Fig 4.

Flow diagram of all patients treated with a two stage revision during the entire study period.

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Table 6.

Comparison of the literature of the reinfection rates (RR) after 1-stage procedures.

The follow-up period started after the first revision (m = months).

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Table 7.

Comparison of the literature of the reinfection rates (RR) after 2-stage procedures.

The follow-up period started after the first revision (m = months). In the series of Flint et al. and Grimer et al. (*patient survival 109m), it is not clear at which point in time follow up began.

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