ABSTRACT
In 1972 the authors began working on a limb amputation method using custom endoprostheses. Because of the biomechanical characteristics of these prostheses, good long-term results have been achieved. The current study presents the analysis of 27 cases, including 11 total femoral replacements, with a followup between 10 to 24 years (median, 14.4 years), with an overall score of 75% using the International Symposium On Limb Salvage evaluation system. Analyzing this surviving group, the authors realize that proximal humerus and proximal femur prosthesis with total or partial joint replacement have better scores of prosthetic survival, limb function, and patient acceptance and the lowest rates of mechanical complications. However, the replacement involving the knee had more complications and worse scores. The authors conclude that the simplest prosthetic design implanted had the fewest intrinsic prosthetic complications. Reducing the stiffness of a prosthesis and increasing the range of movement of the joint involved decreasing the stress forces between the prosthesis and the bone. This may have contributed to the favorable outcomes reported in the series.
