Compressive Osseointegration Modular Prosthesis; Its Complications and Survival: A Systematic Review

Introduction: Minimal remaining bone is one condition that often complicates the limb salvage procedure. Compressive osseointegration is one of the latest modalities with a potential as a solution for this condition. While this modality is promising, the research on its effectivity and longevity on managing limb salvage in musculoskeletal tumor has not been widely studied, particularly in terms of complications and 5-year and 10-year implant survival rate. Materials and Methods: We comprehensively searched PubMed, Google Scholar, Cochrane Library, Science Direct, and Scopus for researches related to compressive osseointegration up to May 2021, which resulted in 89 articles. All publications were then reviewed by the authors based on PRISMA guidelines, which qualified 10 articles for systematic review. Results: Compressive osseointegration has been reported to have a high 5-year & 10-year survival rate, up to 95% and 93% respectively, which are comparable to earlier models of implants. Earlier studies reported mechanical failure and prosthetic infection to be the most common complications to occur in compressive osseointegration, and occurred mostly before their second postoperative year, where mechanical failure is mostly caused by fall and strenuous activities on younger patients. Conclusion: Compressive osseointegration is a promising limb salvage endoprosthesis design. It offers capability of salvaging limb with minimal amount of bone remaining after resection. Complications that occurs from using this endoprosthesis are mostly aseptic failure, which occurs within two years postoperatively, resulting in 5-year and 10-year survival rate of 85% and 81% respectively. Keywords: compressive osseointegration, limb salvage, tumor, complication, survival