gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

The use of megaprostheses in tumor and revision surgery in 310 patients

Meeting Abstract

  • corresponding author J. Hardes - Universitätsklinikum Muenster, Klinik und Poliklinik für Allgemeine Orthopädie, Muenster
  • A. Streitbuerger - Muenster
  • C. Gebert - Muenster
  • H. Ahrens - Muenster
  • W. Winkelmann - Muenster
  • G. Gosheger - Muenster

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP50

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/nov2005/05nov130.shtml

Published: June 13, 2005

© 2005 Hardes et al.
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Outline

Text

Between 1992 and 2002, endoprosthetic replacement with a MutarsR endoprostheses was performed on 310 patients after resection of a large bone segment. The mean age was 38.2 years (range, 7-89). The average follow-up was 3.5 years. Diagnosis was a malignant bone tumor in 230 patients, metastasis in 35, soft tissue sarcoma with bone involvement in 8, lymphoma in 3 and benignant tumours or tumour like lesions in 5 patients. In 29 patients the operation was performed in the case of revision surgery after failed endoprosthetic replacement or in the case of a comminuted fracture. The most common type of replacement was the distal femur in 104, proximal femur in 69, proximal humerus in 50 and proximal tibia in 41 patients.

The most common complication was infection in 30 patients (9.7%), predominantly in proximal femur (17.4%) and proximal tibia replacement (12.2%). Aseptic loosening was noted in 28 patients (9.0%), most common in a distal femur replacement (16.3%). Dislocation of a proximal femur replacement occurred in 10.1% of patients. However, no patient with a bipolar cup had dislocation. Wear of the load-bearing surfaces in distal femur replacement was noted 3.8%. Stem breakage occurred in 5 patients. At last follow-up, 22 patients had failed limb salvage because of recurrence and infection. In 4 patients amputation was avoided by rotationplasty.

Limb salvage with endoprosthesis was in most cases successful. The most common reasons for amputation or rotationplasty were recurrence and infection. Mechanical failures did not lead to amputation.