Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis.
BACKGROUND
The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP). We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival.


METHODS
Eight patients (four males and four females) with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5), Ewing's sarcoma (1), and chondrosarcoma (2). Mean followup was 33 months (9-72 months) for all and 40 months (24-72 months) in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival.


RESULTS
There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%). The implant survival was 88% at 5 years with only one TFP needing removal because of infection.


CONCLUSIONS
A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.
Department of Orthopaedic Oncology, Tata Memorial Hospital, Mumbai, India.
Ajay
A
Puri
Ashish
A
Gulia
Wai Hoong
WH
Chan