A 17-Year Follow-Up after Total Tibial Replacement in the Course of an Osteosarcoma followed by Total Leg Replacement

We report a case of an initially 16-year-old female patient, diagnosed with an osteosarcoma of her left proximal tibia. Treatment consisted of tumor resection in combination with the implantation of a customized tumor prosthesis and chemotherapy. The patient developed a deep infection and several additional surgeries were inevitable. Because of increasing bone loss the distal tibia anchoring was insufficient and a custom-made total tibial prosthesis was designed and implanted to brace against the talus. After 17 years the femoral component became loose and the upper part of the prosthesis had to be exchanged with a total femur prosthesis. To our knowledge, there is no other case reported in the literature where a patient had to be treated with a prosthesis replacing the entire femur and tibia.