Complications Occurring After Reconstruction Of Bone Defects At The Knee With Tumor Endoprostheses

Objective To retrospectively analyze the prosthesis survival and complications after custom-made tumor prosthesis replacement of knee joint.Discuss the factors on which we should focus during the surgery and peri-postoperative period.Methods Data of 214 patients with bone tumors around knee joints,who underwent custom-prosthetic replacement from January 2003 to January 2013,were retrospectively analyzed.The diagnoses were osteosarcoma(n = 136),giant cell tumor(n = 49),aneurysmal bone cyst(n = 1),fasciculated sarcoma(n = 3),malignant fibrous histiocytoma(n = 10),chondrosarcoma(n = 6),chondroblastoma(n = 1),metastatic tumor(n = 4)and other types of bone tumors(n = 3),The distal femur was affected in 150 patients and the proximal tibia in 64.Results Totally 187 patients were followed up for a mean period of 47 months(16-122 months).Complication occurred in 47 patients: early stage infection or nonunion of wounds(n = 15),peroneal palsy(n = 3),late infection(n = 5),aseptic loosening(n = 15),breakage of prosthesis(n = 4)and periprosthetic fracture(n = 5).The overall complication rate was 25.13%.The complication rate within 3 years was11.76%,was 5.35% during 3 to 5 years after the surgery,was 8.02% after 5 years of surgery.The overall complication rate was 21.01% in distal femur,34.69% in proximal tibia.Conclusion The complication rate of proximal tibia tumor was higher than the rate of distal femur.Common complication of tumor prosthesis replacement of knee joint were: aseptic loosening,infection or nonunion of wounds,peroneal palsy,late infection,aseptic loosening,breakage of prosthesis and periprosthetic fracture.Common complication of tumor prosthesis replacement of knee joint could be treated and prevented.