Lower limb salvage surgery with MUTARS endoprostheses: 2 to 7 year results

The reconstruction of bone defects remains a challenge in orthopaedic oncology. Allogenic and autologous bone grafts, as well as megaprostheses are well-recognised methods for bone reconstruction. Modular, both cemented and cementless, endoprosthetic systems have become more popular to bridge defects of different sizes. The clinical and radiological results of 50 consecutive patients treated with MUTARS endoprostheses between 1995 and 2000 were evaluated in a prospective clinical study. The average follow-up was 46 months (25-86 months). Clinical evaluation showed good results with an average Enneking-Score of 72% (33-100%, SD +/- 19). Radiological evaluation showed various patterns of bone remodelling including extracortical bone bridging. Early symptomatic loosening occurred in 11 cases, necessitating revision surgery. In conclusion, the use of the MUTARS Endoprosthesis may be a valuable tool in the treatment of major bone defects in the lower limb, if the problems with the first-generation design can be solved.