BACKGROUND: Adjuvant chemotherapy and endoprosthetic replacement for @entity79 of the lower extremity is well established. The specific long-term consequences of these endoprosthetic reconstructions for the @entity1 's affected limb are unknown. METHOD: The oncologic results and the survival of the endoprostheses were reviewed in 32 @entity1 with primary @entity79 of the femur or proximal tibia. There were 26 high-grade @entity242 , and 6 low-grade @entity242 . A proximal femoral endoprosthesis was used for reconstruction in 4 @entity1 , a total or push-through femoral endoprosthesis in 11 @entity1 , a distal femoral endoprosthesis in 15 @entity1 , and a proximal tibial endoprosthesis in two @entity1 . RESULTS: Median survival was 10 years (range, 1.1 to 18.9 years) for @entity1 with @entity1893 , and 8.1 years (range, 7.1 to 10 years) for @entity1 with low-grade @entity242 . Distant metastases developed in seven @entity1 (22%), all with stage IIB @entity242 , with concomitant local recurrence in 3 @entity1 (9%). Five-year overall and disease-free survival rates for high-grade @entity242 were 81% and 73%, respectively. The overall endoprosthetic survival rate was 87% at 5 years, 80% at 10 years, and 56% at 15 years. Median follow-up of the original endoprostheses was 8.3 years (range, 0.6 to 18.7 years). Endoprosthesis-related complications occurred in 13 @entity1 (41%); most complications were mechanical failures. The highest complication rate was found in distal femoral replacements (60%); amputation was necessary in both @entity1 treated with a proximal tibial endoprosthesis. Five endoprostheses (16%) were revised. An amputation of the involved limb was performed in four @entity1 (13%): in two @entity1 because of local recurrence and in the other two @entity1 because of @entity281 . For @entity1 alive at follow-up, the median functional Enneking evaluation score was 22 points (range, 12 to 28 points), with the highest functional scores in @entity1 with a distal femoral endoprosthesis, and the lowest functional scores in @entity1 with total or push-through femoral replacements. CONCLUSION: Endoprosthetic reconstructions gave satisfying functional results in most @entity1 after long-term survival. However, the proximal tibial and distal femoral endoprosthesis are particularly at risk for long-term endoprosthetic complications requiring additional surgical procedures.

Limb salvage surgery for primary XXXX of the lower extremities: long-term consequences of endoprosthetic reconstructions.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity242 :: ('MESH:D012509', 'Disease') :: ['sarcoma', 'sarcomas'] @entity79 :: ('MESH:D001847', 'Disease') :: ['bone sarcomas', 'bone sarcoma'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity1893 :: ('MESH:D008228', 'Disease') :: ['high-grade sarcoma']
@entity79 :: (MESH:D001847,Disease) :: ['bone sarcoma']
