This treatment strategy can provide good local control and excellent functional and radiological results in the management of benign bone lesions of the proximal femur in children.

IntroductionThis study aimed to analyze the midterm outcomes of LUMiC® endoprosthetic reconstruction following periacetabular resection of primary bone sarcomas and carcinoma metastases.Patients and MethodsWe retrospectively reviewed the charts of 21 patients (11 male [52.3%], 10 female [47.6%]; mean age 47 ± 16 years) for whom a LUMiC® endoprosthesis (Implantcast) was used to reconstruct a periacetabular defect after internal hemipelvectomy. The tumor was pathologically diagnosed as Ewing's sarcoma in six (28.5%), chondrosarcoma in 10 (47.6%), and bone metastasis from carcinoma in five (23.8%) patients.ResultsThe median follow‐up of patients was 57.8 months (95% confidence interval: 51.9–63.7). The implant survival rate at 1, 2, and 5 years were 95.2%, 85.7%, and 80.9%, respectively. The overall complication rate was 33.3% (n = 7). Four (19%) complications resulted in reconstruction failure. Total reoperation rate was 28.5% (n = 6). The complications were soft tissue failure/dislocation in two patients, aseptic loosening in one, infection in two, and local recurrence in two. At the time of study, seven patients were alive with no evidence of disease, seven were alive with disease, and seven died of disease. The 5‐year overall survival rate and local recurrence‐free survival rates were 67% and 76%, respectively. The median Musculoskeletal Tumor Society score at final follow‐up was 70% (range: 50%–86.6%).ConclusionWe conclude that LUMiC® endoprosthesis provides good functional outcomes and a durable reconstruct. Even though this reconstruction method presents some complications, it provides a stable pelvis in the management of periacetabular malignant tumors.

Objective The study was aimed to determine the survivorship and functional outcomes of modular endoprosthetic reconstruction in the management of primary and metastatic bone tumors of the lower limbs and to investigate the rate and causes of implant failure. Methods A total of 84 limbs of 82 patients (49 male, 33 female; mean age=48 years, age range=13–78 years) with a minimum follow-up of 12 months in whom resection and modular endoprosthetic reconstructions were performed for primary or metastatic bone tumors of the lower extremity were retrospectively reviewed and included in the study. The mean follow-up was 43 (range=13–119) months. Functional status was assessed using the Musculoskeletal Tumor Society (MSTS) scoring system at the final follow-up. Implant survival was defined as the time from implantation until partial or complete exchange of the prosthesis secondary to mechanical or nonmechanical causes or amputation. The effects of the anatomical site on functional scores and implant survival were statistically analyzed. Additionally, the effects of diagnosis and adjuvant treatments on functional scores, implant survival, and failure rates were investigated. Results At the time of the study, 55 patients were still alive with a mean follow-up of 48 (range=15–119) months. The mean MSTS scores resulting from the final follow-up of all patients and of those surviving were 87.9% (range=16%–100%) and 86.8% (range=16%–100%), respectively. Overall implant survival was 95.2%, 89.2%, 87%, and 87% at 1, 2, 3, and 4 years, respectively. Statistically, both functional scores and implant survival analysis in different anatomical sites were found similar. In 15 of the patients (17.8%), endoprosthetic reconstructions had failed. The causes of failure were soft tissue failure (dislocation) in 5 patients, infection in 5, structural/mechanical failure in 2, local recurrence in two, and aseptic loosening in one. The diagnosis and receiving preoperative and/or postoperative adjuvant treatment did not affect functional scores, implant survival or failure rates. Conclusion The results of this study have shown that modular endoprosthetic replacement can provide satisfactory functional results and a durable mid-term limb salvage option in the management of patients with primary and metastatic bone tumors of the lower limbs. Level of Evidence Level IV, Therapeutic Study

Effects of microprocessor-controlled prosthetic knees on self-reported mobility, quality of life, and psychological states in patients with transfemoral amputations

Relationship between the tilt angle of bipolar radial head prostheses and radiological radiocapitellar instability