Management of complications following tumor endoprosthetic replacement

BackgroundTumor endoprostheses are available as modular systems with which bone defects can be partially reconstructed, usually close to the joints, or as atotal replacement of long tubular bones. As aresult of continuously improved survival times, they are used with bone tumors, skeletal metastases and, increasingly, in revision arthroplasty.ObjectivesPresentation of the most common complications of tumor endoprostheses and a description of their management, including treatment recommendations.Materials and methodsThe current knowledge and our own experience of complication management with the use of megaprostheses are presented.ResultsThe number of tumor endoprostheses procedures is limited, so that a limited number of studies and classifications are available. Periprosthetic infections involving the soft tissues represent the most serious failure after perioperative dying and local recurrence of the tumor. Two-stage revision remains the gold standard in periprosthetic infection, even if one-stage revision is justifiable in selective indications. Periprosthetic infection and local recurrence is associated with the risk of secondary amputations. Mechanical failure can be treated more easily. Specific socket systems for proximal femoral replacement and attachment tubing allow for adequate soft tissue reconstruction, restoration of joint function, and minimize the risk of dislocation.ConclusionsIn comparison to primary arthroplasty, the risk of failure following tumor endoprosthetic replacement is increased but is basically controllable by revision surgery.