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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 183 - 183
1 Sep 2012
Ruggieri P Pala E Henderson E Funovics P Hornicek F Windhager R Temple T Letson D Mercuri M
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Introduction

The current investigation includes a retrospective review of the experience of five Institutions with distal femur megaprostheses for tumor over a twenty year period, to analyze the incidence and etiology of failure, using a new classification system based upon the failure modes.

Methods

Between 1974 and 2008, 2174 patients underwent primary limb preservation for a benign or malignant extremity tumor using a metallic megaprosthesis at five Institutions, 951 (43.7%) were distal femur replacements. Retrospective analysis of complications according to the Letson and Ruggieri Classification was performed and Kaplan-Meier curves of implant survival were defined.

Segmental megaprosthetic reconstruction failures were categorized as mechanical and non-mechanical failures.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 158 - 158
1 Sep 2012
Funovics P Rois S Kotz R Dominkus M Windhager R
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Background

Modular endoprostheses today represent a standard treatment option in the management of musculoskeletal tumors of the lower extremities. Long-term results of these reconstructions, however, are often limited by the course of the underlying disease. We therefore report our experiences in cancer patients with megaprostheses of the lower limb after a minimum of 15 years.

Materials and Methods

62 patients, 34 men and 28 women, with a mean age of 26 years (median, 20; range, 6–83) were included in this investigation with a mean follow-up of 230 months (median, 228; range, 180–342). Endoprosthetic reconstructions of the proximal femur (11), the distal femur (28), the total femur (2) or the proximal tibia (21) were indicated for osteosarcoma (43), chondrosarcoma (5), malignant fibrous histiocytoma (3) or other tumors (11). All patients have received either a KMFTR (22) or a HMRS (40) modular prosthesis; 23 patients had a muscle flap, 14 had a fibular transposition osteotomy and 4 have received an artificial LARS ligament for soft-tissue reconstruction.