title: Surgical difficulties encountered with use of modular endoprosthesis for limb preserving salvage of failed allograft reconstruction after malignant tumor resection.
abstract: We reviewed outcomes and discussed surgical difficulties encountered in 10 patients who had modular endoprosthesis for limb preserving salvage of failed allograft reconstruction after malignant tumor resection. Mean allograft survival time before failure was 127.4 months (range, 14-264 months). Mean length of follow-up since endoprosthesis revision surgery was 62.8 months (range, 16-132 months). There was one endoprosthesis failure, resulting in a mean endoprosthesis survival time of 56.9 months (range, 16-132). Complications included arterial laceration, nerve injury, periprosthetic crack fracture, aseptic loosening, and infection. Modular endoprosthesis remain a viable option that should be considered in any limb preserving salvage of failed allograft reconstructions. However, altered anatomy, poor/short remnant host bone, periprosthetic fractures, inadequate soft tissue coverage and infection remain important difficulties encountered.
authors.affiliation: Klinik und Poliklinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Münster, Germany.
authors.forename: Leon S S
authors.initials: LS
authors.lastname: Foo
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
authors.forename: Marcel
authors.initials: M
authors.lastname: Henrichs
authors.forename: Helmut
authors.initials: H
authors.lastname: Ahrens
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.forename: Arne
authors.initials: A
authors.lastname: Streitbürger
mesh_terms: D000293:Adolescent; D000328:Adult; D001186:Artificial Limbs; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005269:Femur / Q000601:surgery / Q000637:transplantation*; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D006811:Humerus / Q000601:surgery / Q000637:transplantation*; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012516:Osteosarcoma / Q000601:surgery; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000601:surgery; D012512:Sarcoma, Ewing / Q000601:surgery; D013977:Tibia / Q000601:surgery / Q000637:transplantation*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult