Multicenter retrospective study of 2174 patients receiving large segmental tumor endoprostheses at five sarcoma centers over 34 years, asking: how do these implants fail, how often, and does failure pattern depend on anatomic location or time?
When counseling patients preoperatively or evaluating a failing tumor endoprosthesis, use the Henderson five-type framework to set anatomy-specific expectations: a proximal humeral or proximal femoral replacement is most vulnerable to early soft-tissue instability, a hinged distal femoral or proximal tibial replacement to late aseptic loosening, and all sites to infection — which can present years postoperatively and mandates lifetime antibiotic prophylaxis for invasive procedures.
Avoid pooling failures across anatomic sites when reviewing outcomes data, as location-specific trends will be obscured.
Multicenter retrospective study of 2174 patients receiving large segmental tumor endoprostheses at five sarcoma centers over 34 years, asking: how do these implants fail, how often, and does failure pattern depend on anatomic location or time?
When counseling patients preoperatively or evaluating a failing tumor endoprosthesis, use the Henderson five-type framework to set anatomy-specific expectations: a proximal humeral or proximal femoral replacement is most vulnerable to early soft-tissue instability, a hinged distal femoral or proximal tibial replacement to late aseptic loosening, and all sites to infection — which can present years postoperatively and mandates lifetime antibiotic prophylaxis for invasive procedures.
Avoid pooling failures across anatomic sites when reviewing outcomes data, as location-specific trends will be obscured.