BACKGROUND: Megaprostheses are frequently used after segmental resection of bone sarcomas, bone metastases, and in large osseous defects in revision arthroplasty. OBJECTIVES: The incidence of the most common complications associated the use of megaprostheses are reported. The management of complications including therapeutic recommendations are described. MATERIALS AND METHODS: The current knowledge and our own experience of complication management with the use of megaprostheses are presented. RESULTS: Prospective, randomized studies or meta-analyses on this topic are lacking. An analysis of the literature shows that beside the occurrence of a local recurrence, periprosthetic infection remains the most serious complication. Two-stage revision remains the gold standard, but a single-stage exchange of the prosthesis without removing the stems might be possible in selected cases. Infection is associated with a higher risk of secondary amputation. In contrast, mechanical failures (e.g., wear of the bushings in knee replacements and aseptic loosening of the stems) can be treated more easily. Dislocation of a proximal femur replacement can mostly be prevented by using bi- or tripolar cups. CONCLUSIONS: Complications with the use of megaprostheses can be successfully treated by revision surgery in most cases.
BACKGROUND: Megaprostheses are frequently used after segmental resection of bone sarcomas, bone metastases, and in large osseous defects in revision arthroplasty. OBJECTIVES: The incidence of the most common complications associated the use of megaprostheses are reported. The management of complications including therapeutic recommendations are described. MATERIALS AND METHODS: The current knowledge and our own experience of complication management with the use of megaprostheses are presented. RESULTS: Prospective, randomized studies or meta-analyses on this topic are lacking. An analysis of the literature shows that beside the occurrence of a local recurrence, periprosthetic infection remains the most serious complication. Two-stage revision remains the gold standard, but a single-stage exchange of the prosthesis without removing the stems might be possible in selected cases. Infection is associated with a higher risk of secondary amputation. In contrast, mechanical failures (e.g., wear of the bushings in knee replacements and aseptic loosening of the stems) can be treated more easily. Dislocation of a proximal femur replacement can mostly be prevented by using bi- or tripolar cups. CONCLUSIONS: Complications with the use of megaprostheses can be successfully treated by revision surgery in most cases.
Authors: Robert J Grimer; Mohan Belthur; C Chandrasekar; Simon R Carter; Roger M Tillman Journal: Clin Orthop Relat Res Date: 2002-02 Impact factor: 4.176
Authors: Stefan Bielack; Herbert Jürgens; Gernot Jundt; Matthias Kevric; Thomas Kühne; Peter Reichardt; Andreas Zoubek; Mathias Werner; Winfried Winkelmann; Rainer Kotz Journal: Cancer Treat Res Date: 2009
Authors: Eric R Henderson; John S Groundland; Elisa Pala; Jeremy A Dennis; Rebecca Wooten; David Cheong; Reinhard Windhager; Rainer I Kotz; Mario Mercuri; Philipp T Funovics; Francis J Hornicek; H Thomas Temple; Pietro Ruggieri; G Douglas Letson Journal: J Bone Joint Surg Am Date: 2011-03-02 Impact factor: 5.284
Authors: Joseph L Finstein; Joseph J King; Edward J Fox; Christian M Ogilvie; Richard D Lackman Journal: Clin Orthop Relat Res Date: 2007-06 Impact factor: 4.176