Is the Capanna Technique a Reliable Method for Revision Surgery after Failure of Previous Limb-Salvage Surgery?

• Published in: Annals of surgical oncology 2022-02, Vol.29 (2), p.1122-1129
• Main Authors: Li, Minghui, Xiao, Xin, Fan, Junjun, Lu, Yajie, Chen, Guojing, Huang, Mengquan, Ji, Chuanlei, Wang, Zhen, Li, Jing
• Format: Article
• Language: English
• Subjects: Bone cancer; Bone healing; Bone Neoplasms - surgery; Bone surgery; Bone tumors; Complications; Demography; Fibula; Humans; Limb Salvage; Medicine; Medicine & Public Health; Nonunion; Oncology; Osteosarcoma - surgery; Patients; Postoperative; Reconstructive Oncology; Reconstructive surgery; Reconstructive Surgical Procedures; Reoperation; Retrospective Studies; Sarcoma; Surgery; Surgical Oncology; Treatment Outcome; Wound healing
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-021-10506-z

Background Reconstruction of a massive bone defect caused by previous failed limb-salvage surgery in patients with bone sarcoma is challenging. Many procedures have been used, but they all have their inherent disadvantages. The Capanna technique has demonstrated good functional outcomes and a low incidence of complications in primary reconstructive surgery of massive bone defect. However, few studies have focused on its usage in revision surgery after failed primary limb-salvage surgery. Methods Between June 2011 and January 2017, 13 patients underwent revision surgery with the Capanna technique for reconstruction of a secondary segmental bone defect caused by a previous failed surgical procedure. The demographics, operating procedures, graft union, functional outcomes, oncologic outcomes, and postoperative complications of each patient were recorded. Results The current study investigated 13 patients. The rate of limb salvage was 100 %. Bone union was achieved for all patients during a mean time of 8.54 ± 2.15 months (range 4–11 months) at the fibula–host bone junction and 14.92 ± 2.33 months (range 12–21 months) at the allograft–host bone junction. The postoperative complications included wound healing issues and internal fixation loosening. Allograft fracture, nonunion, and infection were not observed. All the patients achieved good functional outcomes, with a Musculoskeletal Tumor Society (MSTS) score of 0.86 ± 0.03 at the latest follow-up visit. Conclusions The Capanna technique is a reliable alternative method for revision reconstruction of a segmental bone defect caused by a previous failed surgical procedure. Level of Evidence Level IV, therapeutic study.