Endoprosthetic reconstructions for bone metastases.

The purpose of the current study was to help define the role that endoprosthetic reconstructions have in the treatment of metastatic bone disease. Of the 522 endoprostheses implanted at the University of California at Los Angeles (UCLA) between December 1980 and January 2002, 37 (6.9%) were used in 37 patients with metastatic disease. Upper extremity locations outnumbered lower extremity locations 2:1. The 20 males and 17 females ranged in age from 10 to 82 years, with a median age of 54 years. Metastatic renal and breast carcinoma predominated and accounted for 60% of the lesions. The lesion was a primary metastasis in 27 patients (73%) and a revision of failed previous surgery in 10 patients (27%). Only five patients experienced local complications none of whom required reoperation or amputation. Thirty-three of the 37 patients died of disease progression at a median of 12 months (range, 4-49 months). Function after endoprosthetic reconstruction for metastatic disease is similar to that of function for endoprosthetic reconstructions used for primary malignant tumors, but clearly is dependent on the patient's general condition. Although infrequently used to treat bone metastases, endoprosthetic reconstruction can be a useful alternative reconstruction in selected situations.