title: Reconstruction of the proximal femur with a modular resection prosthesis.
abstract: BACKGROUND
  Various megaprostheses are currently available for reconstruction of the proximal femur after tumor resection. This study evaluates the survival and complications of a modular megaprosthesis for reconstruction of the proximal femur.
  
  
  METHODS
  We studied the medical files of 109 tumor patients (age range 16-86 years) who underwent proximal femoral reconstruction with the MRP(®) megaprosthesis from 2002 to 2011. There were 70 patients with metastases, 34 patients with bone sarcomas, and five patients with hematological malignancies; 82 were primary and 27 were revision reconstructions. Mean follow-up was 2.5 years; 31 patients had a minimum five-year follow-up. We evaluated the survival and function of the patients, and the survival and complications of the megaprostheses.
  
  
  RESULTS
  Survival was significantly higher for the patients with bone sarcomas compared to those with metastases and hematological malignancies. Mean MSTS functional score was similar between patients with bone sarcomas and those with hematological malignancies and metastases, and between patients with primary and those with revision reconstructions. Overall survival of the MRP(®) megaprostheses was 74 % at 5 and 9 years. Fourteen (13.6 %) major complications occurred at a mean period of 1.4 years (range 3 months to 4.5 years); these included infection (5.8 %), dislocation (3.9 %), local recurrence (2.9 %), and acetabular fracture (1 %).
  
  
  CONCLUSIONS
  MRP(®) megaprostheses are a valuable reconstruction option after tumor resection of the proximal femur.
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Calabró
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
authors.forename: Rupert
authors.initials: R
authors.lastname: Van Rooyen
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Piraino
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pala
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Trovarelli
authors.affiliation: First Department of Orthopaedics, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece.
authors.forename: Georgios N
authors.initials: GN
authors.lastname: Panagopoulos
authors.affiliation: First Department of Orthopaedics, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece.
authors.forename: Panayiotis D
authors.initials: PD
authors.lastname: Megaloikonomos
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Angelini
authors.affiliation: First Department of Orthopaedics, Athens University Medical School, 41 Ventouri Street, 15562, Holargos, Athens, Greece.
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Mavrogenis
authors.affiliation: Department of Orthopedics, Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy. pietro.ruggieri@ior.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Ruggieri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality; D005260:Female; D005266:Femoral Neoplasms / Q000401:mortality / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000401:mortality / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods / Q000401:mortality; D055815:Young Adult
keywords: Limb salvage; MRP®; Megaprosthetic reconstruction; Proximal femur