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

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


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Neoplasms / surgery*
  • Child
  • Female
  • Femur
  • Humans
  • Knee / surgery*
  • Knee Prosthesis
  • Limb Salvage*
  • Male
  • Middle Aged
  • Tibia
  • Time Factors
  • Treatment Outcome