title: The role of limb salvage surgery and custom mega prosthesis in multiple myeloma.
abstract: Nine patients with multiple myeloma underwent limb salvage surgery and custom megaprosthesis replacement for tumours involving long bones. The lower limb was commonly involved with an average age of 47.7 years at presentation. All patients had pathological fractures. Resection and reconstruction was done using custom megaprostheses. A proximal femoral prosthesis was used for proximal femoral tumours and an intercalary prosthesis for tumours involving the femoral shaft. One patient each had total femoral prosthesis and total knee prosthesis. With an average follow-up of 88.2 months, three patients died of their disease. One patient with total knee prosthesis had delayed deep infection requiring removal of the prosthesis and another patient with an intercalary prosthesis had a periprosthetic fracture and declined revision surgery. Radiological evidence of loosening was seen in one patient. The functional outcome was excellent in 3 and good in 3 patients. The 5-year Kaplan-Meier survival rate of the patients was 66.7%.
authors.affiliation: Department of Orthopaedics & Trauma, Madras Medical College & Research Institute, Govt. General Hospital, Chennai, India. drmayilnatarajan@gmail.com
authors.forename: Mayil Vahanan
authors.initials: MV
authors.lastname: Natarajan
authors.forename: Paraskumar
authors.initials: P
authors.lastname: Mohanlal
authors.forename: Jagadesh Chandra
authors.initials: JC
authors.lastname: Bose
mesh_terms: D000328:Adult; D005260:Female; D005598:Fractures, Spontaneous; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000601:surgery*; D019736:Prostheses and Implants; D016896:Treatment Outcome