Prosthetic reconstruction of the femur for primary bone sarcoma

The survival of patients and implants, complications and functional outcome were reviewed in 25 consecutive femoral endoprosthetic reconstructions for treatment of primary hone sarcoma. The diagnosis was chondrosarcoma in II, osteosarcoma in 10, MFH in 3 and Ewing's tumour in 1. Median follow up was 64 months (34 to 219) and median age at operation was 29 years (10 to 70). Twelve remained disease free at review. One had amputation for local recur rence and another was alive with metastases. 11 patients died at a median o f 13 months (5 to 128); 8 from metastatic disease and 3 from other causes. Four implants were revised, at a median of 95 months (53 to 136); two for f ractures of the stem and two for aseptic loosening. Three implants had radi ological evidence of loosening at a median of 43 months (34 to 49). Fourtee n patients had significant complications. The median functional score using the Musculoskeletal Tumour Society system was 68%. In our experience, pros thetic reconstruction of the femur does not compromise survival, although t here is a significant complication rate.