Severe periprosthetic cortical atrophy in the skeletally immature: a report of three cases.

We describe three patients who developed cortical bone atrophy around cemented endoprostheses used for partial femur reconstructions after resection of Ewing's sarcoma. We believe this to be related to remodeling secondary to stress-shielding. Rather than increased porosity and decreased mineral density, the stress-shielding in these skeletally immature patients resulted in altered morphology of the cortical bone, with apparent maintenance of density.