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J Surg Oncol. 2010 Feb 1;101(2):166-9. doi: 10.1002/jso.21441.

Medium to long-term results after reconstruction of bone defects at the knee with tumor endoprostheses.

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1
Department of Orthopaedics, University of Heidelberg, 69118 Heidelberg, Germany.

Abstract

BACKGROUND AND OBJECTIVES:

Limb salvage and reconstruction with tumor endoprostheses is considered as therapeutic standard in the treatment of bone defects at the knee. Few studies report long-term results so far.

METHODS:

Seventy-seven patients who had a cementless or cemented MUTARS endoprosthesis implanted were followed-up for a mean period of 46 months (3-128 months). The defects were due to primary tumor lesions in 69 cases or metastases in 8 cases. The distal femur (n = 49) or the proximal tibia (n = 28) was reconstructed predominantly with cementless implants (femur: 69%, tibia: 92%). The resection of the tumor was intraarticular in 46 and extraarticular in 31 patients.

RESULTS:

After 10 years probability of limb salvage was 92% with a recurrence rate of 3%. Complications were frequent with a revision rate of 58% and lead to a cumulative probability of survival of the initially implanted prosthesis of 57% after 5 years. Locking mechanism failure (n = 15) and aseptic loosening (n = 13) were the most frequent failure modes.

CONCLUSIONS:

Regardless of achieving a low recurrence rate and satisfactory functional results, we found a high complication rate after implantation of a megaprosthesis. This was particularly evident for extraarticular resections and cemented fixation, which should be avoided when possible.

PMID:
19924724
DOI:
10.1002/jso.21441
[Indexed for MEDLINE]

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