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Amputation Following Oncologic Endoprosthetic Limb Salvage.
Emily M Peairs1, Samuel E Broida1, Mikaela H Sullivan1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, U.S.A.
Anticancer Research
|June 29, 2026
Summary
Limb salvage surgery using endoprosthesis has a low amputation rate. Proximal tibia and distal femur replacements show higher amputation risks, often due to infection or recurrence.
Area of Science:
- Orthopedic oncology
- Limb reconstruction surgery
- Prosthetic joint implants
Background:
- Endoprosthetic reconstruction is a key limb salvage technique for bone cancer, aiming to prevent amputation.
- Evaluating the long-term outcomes of these reconstructions is crucial for patient management.
Purpose of the Study:
- To determine the rate of secondary amputation after limb salvage surgery using endoprosthesis.
- To identify factors associated with amputation following oncologic reconstruction.
Main Methods:
- A retrospective review of a single institution's total joint registry was performed.
- Data from 561 patients (586 implants) who underwent primary endoprosthesis placement for oncologic reasons were analyzed.
Main Results:
- Amputation was required in 14 patients (2.5%), with infection (50%) and recurrence (35%) as primary indications.
- The 10-year cumulative incidence of amputation was 2.9%.
- Distal femoral and proximal tibial endoprostheses demonstrated higher amputation rates (p<0.001).
Conclusions:
- Amputation rates following endoprosthetic reconstruction for limb salvage are low.
- Proximal tibia and distal femur endoprostheses are associated with increased amputation risk.
- Late amputations were typically due to infection, while early amputations often resulted from local recurrence.
