title: Long-term followup of uncemented tumor endoprostheses for the lower extremity.
abstract: Between 1982 and 1989, 100 primary lower limb reconstructions were done using the Kotz Modular Femur Tibia Reconstruction System after resection of a malignant tumor. In 32 patients a proximal femur prosthesis was implanted, in 40 patients a distal femur prosthesis was implanted, in 19 patients a proximal tibia component was implanted, in four patients a total femur prosthesis was implanted, and in five patients a total knee prosthesis was implanted. The Kaplan-Meier estimate of the overall survival rate of the prostheses was 85% after 3 years, 79% after 5 years, and 71% after 10 years. The most common reason for implant failure was aseptic loosening in 27% of patients (11 patients; range, 10-121 months) after the initial operation. The other reasons for revision surgery were implant fracture (n 5 4) and infection (n 5 4). Early repair of prostheses-related minor complications, such as worn polyethylene bushings, resulted in a statistically significant reduction of implant failure. After a median followup of 127.5 months after the initial surgery, 51 patients had died and eight patients were lost to followup. Forty-one patients were evaluated clinically and radiologically using the Musculoskeletal Tumor Society score and the radiologic implant evaluation system of the International Symposium on Limb Salvage; these 41 patients had a mean of 80% (range, 40%-100%) of the normal functional capability.
authors.affiliation: Department of Orthopaedic Surgery, University of Vienna, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Mittermayer
authors.forename: P
authors.initials: P
authors.lastname: Krepler
authors.forename: M
authors.initials: M
authors.lastname: Dominkus
authors.forename: E
authors.initials: E
authors.lastname: Schwameis
authors.forename: M
authors.initials: M
authors.lastname: Sluga
authors.forename: H
authors.initials: H
authors.lastname: Heinzl
authors.forename: R
authors.initials: R
authors.lastname: Kotz
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005266:Femoral Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012516:Osteosarcoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures; D013977:Tibia