Large tumor endoprostheses and extracortical bonebridging - 28 patients followed 10-20 years

Aseptic loosening is a common cause of failure in large tumor endoprosthese s. The concept of extracortical bone-bridging was developed to tackle the p roblem of loosening. New bone which forms across the junction of the bone-p rosthesis junction is believed to improve fixation by controlling the trans fer of stresses across the junction as web as by giving additional stabilit y to the prosthesis. Ne present the long-term experience with this concept following major reconstruction after tumor and non-tumor conditions in 31 p atients. The overall function was good for upper and lower limb prostheses. Most pat ients had extracortical bone bridging which was maintained for over 10 year s. In 1/3 of patients this involved over 75% of the prosthetic circumferenc e, Prosthetic survival was best with intercalary devices, followed by proxi mal femoral and distal femoral prostheses. Survival of prostheses in young active patients was similar to that reported in older patients undergoing p rimary joint replacement.