Infection after prosthetic reconstruction in limb salvage surgery.

Among 145 patients that underwent prosthetic reconstruction between 1985 and 1998, infection developed in 18. Osteosarcoma was the most common primary tumour, and staphylococci were the major pathogenic organisms. Infections were controlled in five patients with débridement only and in two patients with a two-stage revision. Arthrodeses were performed in three and amputations in two. In six patients, infection was suppressed with antibiotics but not cured. Pulmonary metastasis developed in four of ten patients in whom chemotherapy was delayed or interrupted. Infection controls were poor in cases of delayed débridement over 2 weeks, in cementless fixation of implant, and soft tissue defects ( P<0.01). Infection after prosthetic reconstruction is not only difficult to treat but also influences the prognosis reverse.