Tumor endoprostheses vs. bone grafts in bone tumor surgery: experiences in Hungary

From 1981 through 1991, 76 bone tumor patients were treated by limb salvage operations at the Orthopaedic Department of the Semmelweis Medical University in Budapest. The bone defect was reconstructed with endoprostheses in 25 cases and with bone grafts in 51 cases. The mean follow-up period of 72 patients was 51 months (minimum 12 months). There were local recurrences in 11% of the patients. The functional rating of the tumor endoprostheses was "excellent" or "good" in 74%. Complications occurred in two cases. The most common complications with bone grafting were infection (9.8%), fracture (11.8%), which did not influence the end result, and nonunion (9.8%), which often occurred in homografts of resection-arthrodesis during chemotherapy. These complications were successfully managed without loss of the limb in all but two cases. The bone grafts were rated as functionally acceptable ("excellent" or "good") in 66% of the patients. The reconstruction of bone defect with bone grafting is suggested in cases of semimalignant and low malignant tumors; however, tumor endoprostheses implantation is preferred in high malignant tumors that need chemotherapy.