{"doi":"10.1002/jso.27094","title":"Survival and failure modes of the Compress® spindle and expandable distal femur endoprosthesis among pediatric patients: A multi‐institutional study","abstract":"BACKGROUND: Expandable endoprostheses can be used to equalize limb length for pediatric patients requiring reconstruction following large bony oncologic resections. Outcomes of the Compress® Compliant Pre-Stress (CPS) spindle paired with an Orthopedic Salvage System expandable distal femur endoprosthesis have not been reported. METHODS: We conducted a multi-institutional retrospective study of pediatric patients with distal femoral bone sarcomas reconstructed with the above endoprostheses. Statistical analysis utilized Kaplan-Meier survival technique and competing risk analysis. RESULTS: Thirty-six patients were included from five institutions. Spindle survivorship was 86.3% (95% confidence interval [CI], 67.7-93.5) at 10 years. Two patients had a failure of osseointegration (5.7%), both within 12 months. Twenty-two (59%) patients had 70 lengthening procedures, with mean expansions of 3.2 cm (range: 1-9) over 3.4 surgeries. The expandable mechanism failed in eight patients with a cumulative incidence of 16.1% (95% CI, 5.6-31.5) at 5 years. Twenty-nine patients sustained International Society of Limb Salvage failures requiring 63 unplanned surgeries. Periprosthetic joint infection occurred in six patients (16.7%). Limb preservation rate was 91% at 10 years. CONCLUSIONS: There is a high rate of osseointegration of the Compress® spindle among pediatric patients when coupled with an expandable implant. However, there is a high rate of expansion mechanism failure and prosthetic joint infections requiring revision surgery. LEVEL OF EVIDENCE: Level IV, therapeutic study.","journal":"Journal of Surgical Oncology","year":2022,"id":275716,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9445,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":945754,"name":"V Andaya","orcid":null,"position":1,"is_corresponding":false},{"id":411467,"name":"Steven W. Thorpe","orcid":"0000-0003-3127-4912","position":2,"is_corresponding":false},{"id":586988,"name":"Kenneth R. Gundle","orcid":"0000-0003-0451-0561","position":3,"is_corresponding":false},{"id":945755,"name":"James B. Hayden","orcid":null,"position":4,"is_corresponding":false},{"id":945756,"name":"Yee‐Cheen Duong","orcid":null,"position":5,"is_corresponding":false},{"id":876082,"name":"Raffi S. Avedian","orcid":"0000-0001-6224-7410","position":6,"is_corresponding":false},{"id":876081,"name":"David G. Mohler","orcid":"0000-0002-8869-139X","position":7,"is_corresponding":false},{"id":945265,"name":"Lee Jae Morse","orcid":"0000-0001-7028-1459","position":8,"is_corresponding":false},{"id":771559,"name":"Melissa N. Zimel","orcid":"0000-0003-0089-3753","position":9,"is_corresponding":false},{"id":945266,"name":"Richard J. O’Donnell","orcid":"0000-0002-6366-2701","position":10,"is_corresponding":false},{"id":945267,"name":"Andrew Fang","orcid":"0000-0003-0674-5815","position":11,"is_corresponding":false},{"id":411468,"name":"R. Lor Randall","orcid":"0000-0002-3660-774X","position":12,"is_corresponding":false},{"id":945268,"name":"Tina H. Tran","orcid":"0000-0003-1376-2197","position":13,"is_corresponding":false},{"id":945757,"name":"Christin New","orcid":null,"position":14,"is_corresponding":false},{"id":771558,"name":"Rosanna Wustrack","orcid":"0000-0001-8512-5344","position":15,"is_corresponding":false},{"id":945758,"name":"other members of Study Group FORCE","orcid":null,"position":16,"is_corresponding":false},{"id":945264,"name":"K. Tanaka","orcid":"0000-0003-0825-186X","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T00:28:21.971703Z","pmid":"36112398","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}