Reconstruction of distal femoral defects following resection of malignant tumours by modular prosthesis

ABSTRACT

Modular prosthesis is a method used for reconstruction of distal femoral defects following resection of malignant tumours. Tremendous progress in bioengineering during the last decades has made it more widely used than the other reconstructive modalities. The aim of this study was to calculate the average prosthetic survivorship and functional outcome of distal femoral prosthesis. This study included 37 patients with malignant tumours of the distal femur that were treated in our institution by wide resection and reconstruction by distal femoral modular prosthesis. They were followed up for an average of 34 months [range 12-91 months]. Local recurrence occurred in 6 patients and chest metastases in 12 patients. Using Kaplan-Meier statistical analysis prosthetic survivorship was 85.9% at 2 years, 69.3% at 3 years and 61% at 5 years. Factors like age, sex, length of resection, type of prosthesis had no significant; atistical impact on prosthetic survivorship. There were 9 prosthetic failures due to infection [4], aseptic loosening [3] id prosthetic breakage [2]. The average functional outcome cording to the musculoskeletal tumour society scoring stem was 86% [range 70-100%]. None of the factors [age, x, length of resection, available muscles and type of prosthesis] had a statistically significant impact on the functional outcome when tested using the Mann-Witney procedure. In conclusion this study shows that two thirds of patients with malignant tumours of the distal femur treated by limb salvage survive their illness. The use of modular prosthesis to reconstruct the distal femoral defect offers an acceptable functional activity for daily living. Moreover, 61% of these prostheses can last 5 years and prosthetic failures are manageable without jeopardizing limb survival