rühergebnisse nach Defekt-rekonstruktion an der unteren Extremitàt mittels MUTARS®1-Endoprothesen

The bridging of bone defects is a well known problem in the orthopedic oncology. Allogenic and autologic bone grafts, as well as the implantation of megaprosthesis are proved methods for bone reconstruction. During the past years modular endoprosthetic systems have become more popular to bridge defects of different sizes individually. The prosthesis can be fixed cemented and/or cementfree. The early results of implanted MUTARS-Endprosthesis were evaluated in a retrospective clinical study at the Orthopedic University of Heidelberg. The system was applied in 24 patients between 1995 and 1998. 23 patients were included in a clinical and radiological follow-up examination. The average follow-up was 17 months (4 to 38 months). Mean age was 41 years (10 to 74 years). In 22 of the 23 patients the operation was indicated because of a bone tumor. Clinical evaluation showed good results with an average Enneking-Score of 62%. The radiological evaluation showed different reactions of the bone examined. Osteopenia, sklerosis and hypertrophy of the bone were detected in almost the same frequency. In two cases loosenings occured and were treated by the implantation of a megaprosthesis for the second time. Three more revisions without alteration of the implant position were necessary because of a luxation of the hip joint, one infection of the prosthesis and one tumor relapse in the soft tissue. During the course of the follow-up examination two patients died because of their progressive tumor disease. The use of the MUTARS-Endoprosthesis has proved to be a valuable tool in the treatment of extended bone defects at the lower limb. The modular design makes an individual bridging of large bone defects, including the hip and/or knee joints, possible with good functional results.