title: Lower limb salvage surgery: modular endoprosthesis in bone tumour treatment.
abstract: We retrospectively analysed 90 patients who underwent "en bloc" resection and modular endoprosthesis reconstruction in the lower limbs between 1987-2003. After proximal femur resection, reconstruction was performed with a modular endoprosthesis by Howmedica (KFTR, designed by Kotz) and modular revision endoprosthesis by W. Link or Lima-Lto (Revision system, designed by Wagner). The knee joint was reconstructed with a modular endoprosthesis (Howmedica, KFTR designed by Kotz) after distal femur or proximal tibia resection. Malignant bone tumours were present in 58 patients (64.5%), benign tumours in 16 (17.8%), metastases in 8 (8.9%), tumour-like lesions in 4 (4.4 %) and non-tumour-related destruction of the femur in 4 patients (4.4%). High-grade tumours were found in the majority of malignant bone tumours (70.7%). Treatment complications, which occurred in 26 patients, were: local recurrence of the tumour, deep infection, acetabular destruction following hemiarthroplasty, recurrent dislocations of endoprosthesis, periprosthetic fracture and hardware problems. In total, 23 patients (25.6%) died due to tumours. Endoprostheses should be considered as a treatment of choice for bone tumours in the hip and knee joint region. Advances in limb salvage surgery are, and will long continue to be, a great challenge for orthopaedic oncologists of the 21st century.
authors.affiliation: Department of Orthopaedic Surgery, Clinical Hospital Centre Zagreb and Zagreb University School of Medicine, Zagreb, Croatia.
authors.forename: D
authors.initials: D
authors.lastname: Orlic
authors.forename: M
authors.initials: M
authors.lastname: Smerdelj
authors.forename: R
authors.initials: R
authors.lastname: Kolundzic
authors.forename: M
authors.initials: M
authors.lastname: Bergovec
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001186:Artificial Limbs; D001843:Bone Cements / Q000627:therapeutic use; D001858:Bone Nails; D001859:Bone Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D002648:Child; D005260:Female; D005598:Fractures, Spontaneous / Q000628:therapy; D006801:Humans; D023821:Limb Salvage / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies
chemical_list: D001843:Bone Cements