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U. Lenze","\u002Fen\u002Fteam\u002Flenze",{"name":305,"created_at":306,"published_at":307,"updated_at":308,"id":309,"uuid":310,"content":311,"slug":441,"full_slug":442,"sort_by_date":96,"position":443,"tag_list":444,"is_startpage":12,"parent_id":445,"meta_data":96,"group_id":446,"first_published_at":447,"release_id":96,"lang":195,"path":96,"alternates":448,"default_full_slug":449,"translated_slugs":450},"Wachstumsprothese","2020-02-01T15:46:06.111Z","2026-10-07T13:34:07.286Z","2026-10-07T13:34:07.796Z",6379070,"80bdd36c-bf5a-45ff-b436-2c684df156c9",{"_uid":312,"body":313,"image":435,"intro":436,"component":437,"meta_title":241,"text_style":438,"component_style":439,"meta_description":440,"hide_contact_form":12},"084ba5e0-a756-44b5-8bfe-03aa84616065",[314,320,325,331,343,348,353,359,368,373,378,387,395,403,412,417,422],{"_uid":315,"text":316,"component":317,"text_style":318,"component_style":319},"93d7c0eb-0cfd-479f-9199-bea3548e8588","# Growth prosthesis\n\nMalignant bone tumors (osteosarcoma, Ewing's sarcoma) often occur in the growing child and require an interdisciplinary treatment concept, in which chemotherapy plays an important role and has decisively improved the prognosis of those affected. However, the tumor must always be surgically removed completely, leaving only healthy tissue. Whereas in the past amputations or disfiguring rotationplasty surgery were unavoidable, today there are much better alternatives in many cases, especially for children and adolescents of growing age. Since the survival rate has improved significantly, it is important to deal with reconstruction and the consequences after tumor removal at an early stage so that all options are open later.","Text",[],[],{"_uid":321,"text":322,"component":317,"text_style":323,"component_style":324},"0df5387f-2f61-4928-8aa7-98df310e851d","## It depends on the location of the tumor",[],[],{"_uid":326,"text":327,"component":317,"text_style":328,"component_style":329},"d1979edb-d551-4e7f-aac0-3097d805f72e","If the tumor is located in the middle of the shaft, the resulting defect can be completely biologically reconstructed in a joint-preserving manner without having to permanently use foreign materials. Later lengthening is also possible, so that in these rather favorable cases almost a normal condition is the prospect again. But even if the tumor, which is often the case, is located close to the joint and the patient's own joint and the growth plate cannot be preserved, this does not mean that leg length differences have to be permanently accepted. The \"biological\" growth prosthesis (BioXpand) replaces the patient's own joint and can lengthen the remaining bone with callus distraction after completion of the length growth, which means that excellent long-term results can be expected. It is therefore important to choose the right reconstruction procedure from the beginning. Early contact with the ZEM-Germany is therefore particularly important so that all options are open later. ZEM-Germany also cooperates with large tumor centers in Germany and abroad, so that the primary treatment can also be continued there if desired and, if necessary, only the later reconstruction can then be carried out optimally in our specialized center.",[],[330],"lg:col-span-8",{"_uid":332,"image":333,"title":336,"component":337,"copyright":9,"image_style":338,"component_style":341},"e2164bed-616a-4f86-bed6-447019da984c",{"id":334,"alt":96,"name":9,"focus":96,"title":96,"filename":335,"copyright":96,"fieldtype":11},1773208,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F777x1552\u002F302c626ec0\u002Fcase10_2.jpg","Osteosarcoma distal femur","Image",[339,340],"object-contain","w-64",[342],"lg:col-span-4",{"_uid":344,"text":345,"component":317,"text_style":346,"component_style":347},"d9be6ecc-9ef0-4783-8687-0a6e87205f42","## The operation must be discussed at an early stage\n\nUnder the stress of a devastating diagnosis and stressful chemotherapy, there is unfortunately hardly any time to think about the operation and its consequences. Nevertheless, it is important to make the right decision, because after the tumor has been removed, a bony defect remains that should be biologically restored whenever possible. Depending on the procedure, both legs are the same length after the initial operation in the beginning, but the growth on the opposite side causes a leg length difference, the extent of which depends on whether a growth plate had to be removed and how old the affected child is at the time of the operation. It is important to decide on the proper course of treatment from the beginning.",[],[],{"_uid":349,"text":350,"component":317,"text_style":351,"component_style":352},"68b4ab17-8384-40e2-abc3-acd14bdcc36c","## Growth prostheses, the better alternative to rotationplasty",[],[],{"_uid":354,"text":355,"component":317,"text_style":356,"component_style":357},"5b62417d-d53e-481d-a93c-fb008e44f46d","The patented Xpand growth prosthesis is a tumor endoprosthesis with a FITBONE distraction nail drive inside. After removal of an osteosarcoma or Ewing's sarcoma, this prosthesis can be used to compensate for a leg length discrepancy in children due to the growth in length of the opposite side by lengthening the prosthesis body. The target group for these prostheses is adolescents from about the age of 12, in whom a leg length discrepancy of 3 to 4 cm is to be expected. In younger patients, in whom a considerably larger leg length difference can develop, a BioXpand growth prosthesis is much more advantageous. With these innovative growth prostheses developed at ZEM-Germany, new bone can be created, as it is not the prosthesis body that is lengthened, but the remaining bone.",[],[358],"lg:col-span-5",{"_uid":360,"image":361,"title":364,"component":337,"copyright":9,"image_style":365,"component_style":367},"c38e3293-a7a3-46a9-b5a4-1b258a421301",{"id":362,"alt":96,"name":9,"focus":96,"title":96,"filename":363,"copyright":96,"fieldtype":11},2692143,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F6083x3089\u002F0b2c23ddd3\u002Fbioxpand.png","BioXpand femur",[366,339],"max-h-128",[],{"_uid":369,"text":370,"component":317,"text_style":371,"component_style":372},"9db3dc10-baf8-421a-85b4-cc51376399e2","## The BioXpand is the result of years of experience\n\nThe BioXpand was patented in 2006 and used in a patient for the first time in the world at ZEM-Germany in 2007. Startlingly good results were achieved with the first cases, encouraging further development of the system. The basic principle of the BioXpand, that the remaining bone can grow instead of the prosthesis, is implemented in all models. For this purpose, the prosthesis is first anchored with a polished stem that does not grow into the bone, as initially both legs are still the same length. Further surgery is required only when the leg length difference has reached about 3-4 cm due to the growth of the opposite side. With the BioXpand I, an exposure or even a change of the prosthesis, and thus a \"large\" surgical exposure, is necessary for the change from the initial, polished stem to a FITBONE distraction nail and for any subsequent change, e.g. also to the definitive remaining, ingrowing stem after the end of growth. In the femur, the associated risk of infection was drastically reduced with the introduction of the BioXpand II. While retaining all the advantages of BioXpand I, the BioXpand II requires only minimal surgical access, as all replacement procedures are performed from the opposite side of the bone to the prosthesis via a small skin incision (max. 3 cm) and the prosthesis itself remains virtually untouched. Initially, BioXpand II was only available for use in the femur (thigh). Plans and first prototypes (BioXpand III) already exist at ZEM-Germany that will allow all follow-up operations, including exchanges in the lower leg, to be performed without renewed major surgical access in the area of the prosthesis.",[],[],{"_uid":374,"text":375,"component":317,"text_style":376,"component_style":377},"33e47ed5-f845-4885-933c-a3738111575b","## The treatment proceeds in several steps",[],[],{"_uid":379,"image":380,"title":383,"component":337,"copyright":9,"image_style":384,"component_style":385},"67747746-b1e9-4773-9108-8eefeec718a1",{"id":381,"alt":96,"name":9,"focus":96,"title":96,"filename":382,"copyright":96,"fieldtype":11},1773204,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F790x1581\u002Ff12288b779\u002Fcase10_3.jpg","Shortening of the left leg after tumor resection",[],[386],"col-span-3",{"_uid":388,"image":389,"title":392,"component":337,"copyright":9,"image_style":393,"component_style":394},"c84b7f74-cf29-4b1b-a4dc-9bc4c6375177",{"id":390,"alt":96,"name":9,"focus":96,"title":96,"filename":391,"copyright":96,"fieldtype":11},1773203,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F804x1608\u002Fcd9f3a2c75\u002Fcase10_4.jpg","Femur and Tibia Lengthening with BioXpand Type II",[],[386],{"_uid":396,"image":397,"title":400,"component":337,"copyright":9,"image_style":401,"component_style":402},"8997f2f6-8138-40fc-9ce5-a6fdabbcc496",{"id":398,"alt":96,"name":9,"focus":96,"title":96,"filename":399,"copyright":96,"fieldtype":11},1773205,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F808x1617\u002F430ff8d02d\u002Fcase10_6.jpg","Not the prosthesis but the bone was lengthened",[],[386],{"_uid":404,"image":405,"title":409,"component":337,"copyright":9,"image_style":410,"component_style":411},"f6045b3e-ea3e-4c2b-89a4-3c832ac2d312",{"id":406,"alt":96,"_uid":407,"name":9,"focus":96,"title":96,"filename":408,"copyright":96,"fieldtype":11},1773206,"0a75ff1e-52ba-41e5-a940-68bafdfdaaa0","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F1722x3442\u002Fb2715bc97a\u002Fcase10_5.jpg","Equal leg lengths despite removal of the growth plate",[],[386],{"_uid":413,"text":414,"component":317,"text_style":415,"component_style":416},"0b662bdf-6f7c-471f-a194-acc0c9bb64d6","In the case of malignant bone tumors, complete removal of the bone tumor and the surrounding soft tissues is still the priority in the primary operation, as the survival of the patient depends on this. If the decision has been made to use a BioXpand, an interim prosthesis with \"smooth, polished\" stems should always be used in the primary operation, which initially ensures optimum stability and later keeps all options open. It is also important to bear in mind that children are weakened by the chemotherapy at this stage, and the ultimate prognosis is not yet clear. The BioXpand is basically available for all common locations of malignant bone tumors in the lower extremities, i.e. for the proximal and distal femur and the proximal tibia. With the BioXpand II, all follow-up operations for lengthening at the femur can be performed in a minimally invasive technique via small incisions. In the future, the patented BioXpand III will make this possible in both the femur and the tibia, so that only once, during tumor resection, a large surgical approach is required, a prospect that seemed unthinkable until recently.",[],[],{"_uid":418,"text":419,"component":317,"text_style":420,"component_style":421},"2f3b3eaa-9096-4eb0-987d-3a814fb6016b","## Even later, the BioXpand is still an option\n\nIn principle, it is always possible to change to a BioXpand if this results in a meaningful improvement in the treatment options for the affected child. If a polished stem has been inserted, a change is relatively simple. However, if the primary prosthesis was inserted with coated stems that have grown firmly into the bone, the indication to BioXpand must be carefully considered, since removal of these stems is only possible in an extremely invasive manner. This makes it all the more important to choose a reconstruction strategy from the outset that does not make subsequent treatment more difficult or impossible. Therefore, you should seek advice at ZEM-Germany even if the tumor operation is to be performed in another clinic.",[],[],{"_uid":423,"title":72,"stories":424,"component":434},"d78f642d-1caa-4e9a-b28f-15487d9f0021",[425],{"uuid":426,"full_slug":427,"content":428},"443ad2d9-6879-4088-9023-58b158e59c7d","en\u002Fcases\u002Fosteosarcoma",{"_uid":429,"_editable":-1,"image":430,"intro":433,"meta_title":284},"afeb174a-53c1-4757-838f-18a9d18869f2",{"id":431,"alt":96,"name":9,"focus":96,"title":96,"filename":432,"copyright":96,"fieldtype":11},1773207,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F56859\u002F768x1538\u002F8b18faf437\u002Fcase10_1.jpg","A 9-year-old patient was diagnosed with a high-grade malignant osteosarcoma in the left distal thigh. The left knee joint had to be removed. Despite the need for a tumor endoprosthesis, the boy has two legs of equal length again.","Reference",{"id":362,"alt":96,"name":9,"focus":96,"title":96,"filename":363,"copyright":96,"fieldtype":11},"When a malignant bone tumor (osteosarcoma, Ewing's sarcoma) is diagnosed in children and adolescents, not only the tumor but often also the growth plate must be resected. The normal growth of the opposite side results in a leg length difference. With a new type of \"biological growth prosthesis\" (BioXpand) developed at ZEM-Germany, the remaining bone can be lengthened, which in many cases makes disfiguring rotationplasty unnecessary, and opens up completely new reconstruction options.","Page",[],[],"Growth prostheses allow leg lengthening in children with bone tumors who have had to have their own joint removed.","wachstumsprothese","en\u002Fexpertise\u002Fgrowth-prosthesis",110,[],780693,"4e4b24d9-4a47-4cb6-970d-da433805125e","2021-05-17T15:59:52.000Z",[],"spezialgebiete\u002Fwachstumsprothese",[451,453,457,461,465],{"path":452,"name":241,"lang":195,"published":21},"expertise\u002Fgrowth-prosthesis",{"path":454,"name":455,"lang":456,"published":21},"espectro-de-tratamiento\u002Fprotesis-de-crecimiento","Prótesis de crecimiento","es",{"path":458,"name":459,"lang":460,"published":21},"tyf-alalaj\u002Fbdlh-alnmw","بدلة النمو","ar",{"path":462,"name":463,"lang":464,"published":21},"spektr-lecheniya\u002Fprotez-rosta","Протез роста","ru",{"path":466,"name":467,"lang":468,"published":21},"zhi4-liao2-fan4-wei2\u002Fsheng1-zhang3-jia3-ti3","生长假体","zh",1792469120762]