Endoprosthetic Reconstruction

⚙️What This Procedure Involves

After the tumour-bearing bone segment is removed, a metal prosthesis (endoprosthesis) is implanted to replace the bone and joint. The prosthesis is fixed into the remaining bone with a cemented or uncemented stem. Soft tissues, muscles, and tendons are reattached to the prosthesis where possible. Common sites include the distal femur, proximal tibia, proximal femur, and proximal humerus. The reconstruction phase takes one to three hours (in addition to the resection).

💡Why It May Be Recommended

Endoprosthetic reconstruction provides immediate structural replacement and early mobilisation. It is the most commonly used reconstruction method for bone tumours around the knee, hip, and shoulder.

⚖️Non-Operative Alternatives

Biological reconstruction (bone graft or allograft), rotationplasty, or amputation are alternatives depending on the clinical situation.

📋Preparing for Surgery

Specialist sarcoma centre. Pre-operative imaging for implant planning. Custom prostheses may need several weeks to manufacture.

✅Expected Benefits

Preservation of the limb with functional joint replacement. Most patients achieve useful limb function. Modern endoprostheses have good longevity with approximately 75-85% survival at ten years.

⚠️Common Risks

• Functional limitationExpected

  Some loss of function compared to a normal limb is expected.

• InfectionUncommon

  Risk approximately 5-10% — higher than standard joint replacement due to the extensive surgery and often concurrent chemotherapy.

• Mechanical complicationsLong-term

  Over time, the prosthesis may wear, loosen, fracture, or dislocate.

🔴Less Common but Serious Risks

• Deep infectionUncommon

  May require implant removal and revision surgery or, rarely, amputation.

• Aseptic looseningLong-term

  The implant may become loose over time.

• Periprosthetic fractureUncommon

  Fracture around the implant.

• Soft tissue failureUncommon

  Muscles and tendons may fail to reattach adequately, limiting function.

• Bushing wearLong-term

  In hinge-type prostheses, the hinge mechanism wears and may need replacement.

💉Anaesthetic Considerations

General anaesthesia. Major surgery with significant blood loss.

🏃Recovery and Rehabilitation

Hospital stay one to two weeks. Rehabilitation programme supervised by a specialist physiotherapist. Weight-bearing depends on the site — lower limb endoprostheses may require protected weight-bearing for six to eight weeks. Upper limb prostheses begin gentle movement early. Return to light activity at three months. Full recovery six to twelve months.

📅Follow-Up

Oncology surveillance at regular intervals. Prosthesis monitoring with X-rays. Long-term lifelong follow-up.

❓Frequently Asked Questions