Aim: The long- term results of selective patients undergoing resection of primary malignant tumours followed by allograft arthrodesis of the hip supplemented by vascularised þbula were prospectively studied. Patients and methods: 8 patients underwent resection of the primary malignant tumor of the proximal femur followed by reconstruction with allograft arthrodesis and vascularised þbular graft. The patients were clinically assessed by MSTS functional scoring system and radiologically assessed at regular intervals. All the patients were male with a mean age of 29 years (range18–39). The diagnoses included, Ewingñs sarcoma in three patients, Osteosarcoma and MFH in two patients each and Chondrosarcoma in one patient. Results: 2 patients died of extensive systemic disease without any local recurrence. At a mean follow-up was 112 months (range 28–153), the remaining six patients scored good or excellent in the MSTS scoring system and are engaged in physically active occupations. Radiologically, in three cases there was evidence of fracture of the allograft with loosening of the screws holding the plates but without the failure of the construct. The þbular graft hypertrophied with time in all the cases. Conclusions: Our experience clearly indicates that resection arthrodesis of the hip with allograft supplemented by vascularised þbula is a useful limb salvage procedure with the þbula hypertrophying slowly with time. This is especially so in carefully selected physically active patients who have poor long-term survival with resection followed by custom-made prosthesis.

Aim: The long-term results of Cementless Total Knee Replacements have been traditionally unsatisfactory owing to the problems of þxation of the Tibial component. The purpose of this study was to evaluate the long- term results of Cementless Ortholoc I Total Knee Replacement (Wright Medical, Arlington, TN). Patients & methods: Between June 1985 and Dec.1987, 164 patients underwent 187 cementless Ortholoc I TKAs. The Knee Society scoring system was used to assess patients both clinically and radiologically. Kaplan Meier Survivorship analysis was used to assess survival with all revisions and revisions for aseptic loosening alone as end points. Results: 68 patients (83 knees) were dead and 14 were lost. 82 patients (89 knees) were followed up at a mean of 159 months (145–181). Mean age was 71 years (range 35–87) and the majority was female. OA was the commonest indication for surgery. The mean BMI was 28(range 15–46). 42 patients had a high tibial osteotomy prior to their TKA. 13 knees have been revised, 6 of which for aseptic loosening. The Knee Society score at þnal follow-up was 85 (58–98). With any revision as end point the survival at 15 years was 92% and with revision for aseptic loosening as end point it was 96%. Conclusions: Our results with the Ortholoc I TKA has been excellent with a success rate of over 96% at a mean follow-up of nearly 13 years. We believe that the better þxation of the Tibial component is a major factor inßuencing the success of this cementless design of TKA