[Functional results of patients treated with modular prosthetic replacement for bone tumors of the extremities].

Abstract

We evaluated functional results of patients who were treated with cemented modular prosthetic replacement for bone tumors of the extremities. The study included 23 patients (12 males, 11 females; mean age 49 years; range 14 to 81 years) who underwent wide resection and cemented endoprosthetic replacement with the TMTS (Turkish Musculoskeletal Tumor Society) prosthesis for bone tumors. Twelve patients (52.2%; mean age 63.5 years) had metastatic, 11 patients (47.8%; mean age 38 years) had primary tumors. The most common site of involvement was the femur (n=17), followed by the humerus (n=5). Functional evaluations were made with the Musculoskeletal Tumor Society (MSTS) scoring system. The mean follow-up period was 24 months (range 1 to 108 months), being 30 months for primary, and 3 months for metastatic tumors. Postoperative complications were seen in seven patients (30.4%), being local recurrences in three patients. During the follow-up period, 11 patients died due to tumoral causes, distant metastasis developed in three patients, and nine patients were tumor-free. Survival was significantly better in patients with primary tumors (p<0.001). All the patients were able to walk without crutches in the postoperative period. The mean MSTS score was 58.9% (range 40% to 90%) in survivors, which was 71.5% (range 60% to 90%) for primary tumors, and 47.4% (range 40% to 73%) for metastatic tumors (p<0.001). Reconstruction with cemented modular endoprostheses is an appropriate surgical alternative in the treatment of large segmental defects after resection of extremity tumors, with satisfactory functional results particularly in primary tumors.