A CUSTOM DISTAL FEMORAL PROSTHESIS FOR RECONSTRUCTION OF LARGE DEFECTS FOLLOWING WIDE EXCISION FOR SARCOMA - RESULTS AND PROGNOSTIC FACTORS

Between 1979 and 1986, 37 patients with sarcoma of the distal femur un derwent limb salvage using a custom prosthetic knee replacement. Thirt een (35%) had early complications. Fourteen (38%) had late complicatio ns, which consisted of 6 aseptic femoral loosenings, 1 aspectic tibial loosening, 2 tibial fractures, 2 contractures, 1 femoral fracture, 1 prosthetic fracture, and 1 septic loosening. By 1988, nine patients di ed. Thirteen prostheses failed in 12 patients, resulting in 9 revision s, 2 above-knee amputations, and 2 Van Nes rotationplasties. The 2- an d 5-year prosthetic survival rates were 82% and 57%, respectively. Twe nty-two of the 26 survivors (85%) had successful limb salvage. Prevent able factors were implicated in the loosening of six femoral component s and in one femoral fracture. The mean Hospital for Special Surgery K nee Score was 69 (range: 62 to 86).