Osteogenic sarcoma, a highly malignant tumor of bone, is generally treated by amputation. This is a report of 19 cases of excision of the entire femur because of skip areas which are occasionally seen. The femur usually has the lowest cure rate according to site of involvement. In total femur replacement, the whole bone is removed while the limb is saved. The operation consists of isolating the neurovascular bundle and removing the knee joint and femur including some surrounding normal tissue for margin of safety. The femur and knee replacements are made entirely of metal. The resultant extremity is weak, but functional. The patients can walk without support, but their gait is better using a cane and/or an ischial weight bearing brace.
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Marcove et al. (1977) studied this question.