ENDOPROSTHETIC REPLACEMENT FOLLOWING LIMB-SPARING RESECTION FOR BONE SARCOMA

Prosthetic replacements are widely used in the reconstruction of defic its created by surgical resection for bone sarcomas. The longevity, co mplications, and functional outcome of these reconstructions vary by a natomic location, prosthesis type, and mode of fixation. Distal femora l replacement appears to be the most reproducibly successful prostheti c reconstruction, particularly when utilizing a cemented rotating-hing e device. Expandable prostheses may be the only alternative to rotatio nplasty or ablation in the young skeletally immature patient. Aseptic loosening and bone resorption are frequently noted complications of pr osthetic replacement for which successful revision is nearly always po ssible. The incidence of infection has been reduced by use of better s oft tissue coverage. The concept of extracortical bone bridging contin ues to evolve while enhanced tendon attachment emerges as a new develo pment. (C) 1997 Wiley-Liss, Inc.