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Purpose <p>To evaluate long-term implant survivorship, complications, functional outcomes, and radiographic changes following proximal tibial tumour resection and reconstruction using the Global Modular Replacement System (GMRS®, Stryker Orthopaedics, Mahwah, NJ, USA), and to identify factors associated with implant failure and postoperative function.</p> Methods <p>A retrospective review was performed on 61 patients who underwent proximal tibial reconstruction between 2005 and 2015. Implant survivorship, complications according to the Henderson classification, Musculoskeletal Tumor Society (MSTS) scores, Blackburne–Peel Index (BPI), and overall survival were evaluated. Age and resection length were analysed as continuous variables using Cox proportional hazards regression and Pearson's correlation. Mean implant follow-up was 92&#xa0;months.</p> Results <p>Ten-year implant survivorship was 81.9% (95% CI 71.6–92.2). Implant failure occurred in 12 patients (19.7%), exclusively due to periprosthetic joint infection (PJI). Age was not associated with mechanical implant failure but showed a modest association with increased PJI risk (HR risk (HR 1.052; 95% CI 0.941–1.176) or postoperative function (r = –0.015). Soft tissue failure occurred in 22.9% of patients. An increased Blackburne–Peel Index was associated with an extension lag &gt; 15° (mean difference 0.27; 95% CI 0.12–0.42). Mean MSTS scores were significantly lower in infected than in non-infected patients (1.63 ± 0.83 vs. 2.40 ± 1.41).</p> Conclusions <p>The GMRS prosthetic system provides reliable long-term reconstruction following proximal tibial tumour resection. Periprosthetic joint infection remains the principal cause of implant failure, whereas resection length does not appear to adversely influence postoperative function or infection risk. Careful biological reconstruction of the extensor mechanism and maintenance of appropriate patellar height are essential to optimize long-term clinical outcomes.</p>

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Long-term outcomes of proximal tibial tumour resection and reconstruction using the Global Modular Replacement System prosthetic system

  • 期刊论文

  • 发表日期：

    2026年7月24日

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  • Marco Fava,
  • Marco Colangeli,
  • Angelo Toscano,
  • Davide Maria Donati,
  • Giovanna Danna,
  • Nikolin Ali

摘要

Purpose

To evaluate long-term implant survivorship, complications, functional outcomes, and radiographic changes following proximal tibial tumour resection and reconstruction using the Global Modular Replacement System (GMRS®, Stryker Orthopaedics, Mahwah, NJ, USA), and to identify factors associated with implant failure and postoperative function.

Methods

A retrospective review was performed on 61 patients who underwent proximal tibial reconstruction between 2005 and 2015. Implant survivorship, complications according to the Henderson classification, Musculoskeletal Tumor Society (MSTS) scores, Blackburne–Peel Index (BPI), and overall survival were evaluated. Age and resection length were analysed as continuous variables using Cox proportional hazards regression and Pearson's correlation. Mean implant follow-up was 92 months.

Results

Ten-year implant survivorship was 81.9% (95% CI 71.6–92.2). Implant failure occurred in 12 patients (19.7%), exclusively due to periprosthetic joint infection (PJI). Age was not associated with mechanical implant failure but showed a modest association with increased PJI risk (HR risk (HR 1.052; 95% CI 0.941–1.176) or postoperative function (r = –0.015). Soft tissue failure occurred in 22.9% of patients. An increased Blackburne–Peel Index was associated with an extension lag > 15° (mean difference 0.27; 95% CI 0.12–0.42). Mean MSTS scores were significantly lower in infected than in non-infected patients (1.63 ± 0.83 vs. 2.40 ± 1.41).

Conclusions

The GMRS prosthetic system provides reliable long-term reconstruction following proximal tibial tumour resection. Periprosthetic joint infection remains the principal cause of implant failure, whereas resection length does not appear to adversely influence postoperative function or infection risk. Careful biological reconstruction of the extensor mechanism and maintenance of appropriate patellar height are essential to optimize long-term clinical outcomes.