Retrospective analysis of all uncemented massive endoprostheses inserted at our unit in the management of primary bone tumours with a minimum follow up of 5 years.
The rate of infection was 12.5%, aseptic loosening 6%, amputation due to local recurrence 10% and the mortality 21%. All the deaths occurred within 3 years of the implant being inserted and were all due to systemic progression of the disease. The amputations for local recurrence occurred throughout the follow up period, the latest being at 71 months. Revisions for infections and aseptic loosening all occurred early (within 3 years). All cases of aseptic loosening occurred in distal femoral replacements (10%) and were related to divergent canals. Proximal tibial replacements had the highest rate of infection (23%). Rates of infection were not higher in the minimally invasive grower (12.5 %) when compared to the group as a whole.
Retrospective analysis of 25 consecutive metal on metal proximal femoral replacements performed at our unit between 1965 and 1979.
The concentration of Cr, Co, Ti, Al, V, Mo &
Ni in whole blood and urine was also measured by High-Resolution Inductively Coupled Mass Spectrometry and compared with controls and patients with other implants. Retrieved prostheses (in situ for in excess of 25 years) were analysed for roughness and wear using a Mitutoya form tracer and an electron microscope.
In the retrieved prostheses the contact zones were found to be smoother (Ra 0.05?m), have fewer and smaller carbides together with evidence of ‘self-healing’ when compared to the original surface (Ra 0.32?m). Blood &
urine levels of Co &
Cr were significantly elevated. Co levels were exceptionally elevated in loose prostheses but levels quickly fell following revision.
We performed a retrospective analysis of massive endoprostheses inserted at our unit in the management of Giant Cell Tumours of the distal femur with a minimum follow up of 5 years.
We report the case of a 12-year-old boy with polyostotic fibrous dysplasia of the upper femur in whom a massive customised polyethylene prosthesis functioned successfully for more than fifty years.