Endoprosthetic replacements for bone tumors: review of the most recent literature

Purpose of review: To evaluate results following endoprosthetic reconstruction, management of complications, and new concepts that are emerging. Recent findings: Despite improvements, there are still many complications that put salvaged limbs at a high risk. Infection has become the most common of these, and its incidence has not decreased over the years. It can sometimes be managed successfully, but requires aggressive therapy and good quality soft tissue coverage. A new way to fix implant to bone has shown interesting short-term results. Expandable implants offer an appealing alternative for children, and noninvasive lengthening can be achieved without the burden linked to repeated surgery. Revision procedures, unfortunately, are part of the treatment plan. Reports on uncemented implants have been very scarce in this review, and the issue of ‘cemented or cementless’ remains unresolved. Authors reported very low aseptic loosening rates following cementation of tight-fit stems. Reverse shoulder designs need to be explored as a possible means to improving active shoulder motion and function following proximal humeral resection. Rotationplasty is recognized, even in adults, as an effective means of salvaging endoprosthetic complication. Summary: Information published in 2006–07 will impact the way we select implant and reconstruction procedures, as well as the way we prevent and manage complications.