Modular megaprosthesis for proximal femoral tumors

Fifteen patients with proximal femoral tumors had resection and limb salvage with an uncemented Kotz (HMRS) megaprosthesis. There were five osteosarcomas, four chondrosarcomas, one hemangioendothelioma, three fibrosarcomas, and two Ewing's sarcomas. The mean follow-up was 6.7 (range 3-10) years. Two patients died of causes not related to the prosthesis. The postoperative Musculoskeletal Tumor Society score (MSTS) score was 19 (range 12-26) for the remaining 13 patients. There were one aseptic loosening, two infections, and one local recurrence. The most frequent complication was hip dislocation at 20%. Reconstruction of proximal femoral tumors with a modular megaprosthesis is a good procedure, but hip instability remains a major problem.