Page 559 - Withrow and MacEwen's Small Animal Clinical Oncology, 6th Edition

CHAPTER 25 Tumors of the Skeletal System 537

VetBooks.ir

A B C

• Fig. 25.6 Limb salvage surgery. (A) Preoperative lateral radiograph of a distal radial osteosarcoma lesion
in a dog. (B) Craniocaudal specimen radiograph after tumor resection. (C) Lateral postoperative radiograph
after allograft replacement and plate fixation.

occurs, it may be controlled with long-term antibiotic therapy, published in 2006. 214 No significant differences in the number of
but infections are rarely resolved with antibiotics. 162 Infection complications were noted between endoprostheses and allografts.
may result in soft tissue defects from draining tracts, exposure of In a recent study comparing clinical outcome in 45 dogs treated
the plate or allograft, and hardware loosening. Revision surgeries, with either first or second generation endoprosthesis LSS, the
either for hardware complications or soft tissue reconstruction, overall complication rate was 96%, including infection in 78%,
are not uncommon. Additionally, amputation for catastrophic implant-related complications in 36%, and local recurrence in
implant failure, local recurrence, or unmanageable infection is 24% of dogs. 215 An endoprosthesis is an attractive alternative to
sometimes required. cortical allografts for LSS of the distal aspect of the radius in dogs
Metal endoprosthesis. This technique utilizes a commercially because surgical and oncologic outcomes are similar. The com-
available metal endoprosthesis with a modified bone plate (Fig. mercially available endoprosthesis is an off-the-shelf implant with
25.7), 3D printed, or custom-designed endoprostheses. The no need for tissue banking. Various patient-specific, 3D-printed
surgery is nearly identical to the procedure described for corti- endoprostheses have been utilized with good results. 216,217
cal allografts with an endoprosthesis used instead of an allograft. Longitudinal bone transport osteogenesis. Longitudinal bone
A prospective comparison of complications between cortical transport osteogenesis (BTO) is a limb salvage technique reported
allograft and commercially available endoprosthesis LSSs was in dogs (Fig. 25.8) 218–220 that utilizes Ilizarov (circular) fixators