Endoprosthetic reconstruction in 250 patients with sarcoma.
We assessed the clinical results and complications associated with a new endoprosthetic replacement system (Mutars) used in 250 patients with a malignant bone or soft tissue tumor. The key features of the system are its cementless, hexagonal-shaped stem (titanium alloy), the possibility of torsion adjustments in 5 degrees -increments, and the Trevira tube for soft tissue attachment. The mean age of the patients was 30.7 years, and the mean followup was 45 months. Prosthetic survival at 5 years was 89.7% for the upper extremity and 68.5% for the lower extremity. Prosthetic survival without any reoperation was 73.4% at 3 years postoperatively and 60.4% at 5 years postoperatively. Prosthetic failure was caused by deep infection in 12% (30 patients) of patients and aseptic loosening in 8% (20 patients) of patients. Stem fracture occurred in only 1.6% (four patients) of patients. Dislocation rates were reduced by using the Trevira tube. Limb survival was achieved in 82.6% to 93.1% of patients depending on the endoprosthetic replacement site, and functional results ranged between 63% to 83% according to the Tumor Society score. Our results suggest limb salvage with the Mutars endoprosthesis is successful with good functional results.


METHODS
Therapeutic study, Level IV (case series).
Gosheger
Georg
G
Department of Orthopaedics, Universität Münster, Albert-Schweitzer-Strasse 33, 48149 Münster, Germany. goshegg@uni-muenster.de
Gebert
Carsten
C
Ahrens
Helmut
H
Streitbuerger
Arne
A
Winkelmann
Winfried
W
Hardes
Jendrik
J
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D002813:Chondrosarcoma / Q000601:surgery; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000601:surgery; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000601:surgery*