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A Journal on Orthopedics and Traumatology

Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
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Minerva Ortopedica e Traumatologica 2008 October;59(5):299-303

language: Italian

Knee megaprosthesis in tumors: biomechanical causes of failure

Tosco P. 1, Bistolfi A. 1, Boffano M. 2, Brach Del Prever E. M. 1

1 Dipartimento di Ortopedia e Traumatologia AO CTO/Maria Adelaide, Torino, Italia
2 Scuola di Specializzazione in Ortopedia e Traumatologia Università degli Studi di Torino, Torino, Italia


Chemotherapy and advances in radiotherapy allowed limb sparing surgery and reconstruction with many systems. Modular prosthesis are good solution, however biomechanical failures of the implants, unrelated to disease relapses, are greatly increasing in number and severity. The aim of the present study was a review for biomechanical failure of knee megaprosthesis as KMFTR™ and HMRS™. A review of literature was made using Pubmed, Ovid, Scirus and traditional libraries. Keywords “Kotz prosthesis”, “knee megaprosthesis”, “KMFTR”, “HMRS”, in different combinations. Inclusion criteria were English, Italian language; no restriction for the type of paper; at least 25 cases of implant. Seven papers responded to the requests. All the papers were reviews of modular prosthesis reconstruction. The use of mechanical modular prosthesis is recently becoming the gold standard technique in surgical reconstruction of bone tumors, thanks to the good results in functional recovery, but it is still not a procedure without complications. Infections and aseptic loosening of prosthesis are main causes of implant failure, followed by periprosthetic fractures. Bio-mechanical failures of megaprosthesis and polyethylene wear are one of the main surgical revision causes, that could be decreased by research improvement.

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