Endoprosthetic replacement following limb-sparing resection for bone sarcoma

Prosthetic replacements are widely used in the reconstruction of deficits created by surgical resection for bone sarcomas. The longevity, complications, and functional outcome of these reconstructions vary by anatomic location, prosthesis type, and mode of fixation. Distal femoral replacement appears to be the most reproducibly successful prosthetic reconstruction, particularly when utilizing a cemented rotating-hinge device. Expandable prostheses may be the only alternative to rotationplasty or ablation in the young skeletally immature patient. Aseptic loosening and bone resorption are frequently noted complications of prosthetic replacement for which successful revision is nearly always possible. The incidence of infection has been reduced by use of better soft tissue coverage. The concept of extracortical bone bridging continues to evolve while enhanced tendon attachment emerges as a new development.