Limb Salvage Management of Distal Femur Tumors with Custom Prosthesis

Objective To evaluate the role of the custom knee prosthesis in the limb salvage procedure of distal femur tumors.Methods Thirty-eight patients of distal femur tumors(benign tumor,nine patients;malignant tumors,twenty-nine patients)treated with custom knee prothesis were retrospectively reviewed.The benign tumors included seven cases of giant cell tumors(five cases of recurred giant cell tumors,two with pathologic fracture).One case of giant cell tumor with aneurismal cyst,one of osteoblastoma.The malignant tumors included osteogenic osteosarcoma(sixteen patients),metastasis tumor(six patients,two with pathologic fractures),chondrosarcoma(two patients),malignant fibrous histiocytoma(three patients,one with pathologic fracture),fibrosarcoma(one patient),and solitary myeloma(one patient).all patients received limb savage procedure with custom knee prosthesis including sevnteen cases of hinge joint and twenty-one cases of posterior stability joints.Results One of nine patients with benign tumors was lost for followed-up,one patient died of unrelated disease,the remained patients have excellent function in five patients,good function in one case,and one poor according to the Enneking evaluating system.the limb salvage rate was 100%.Seven patients were lost for followed-up in twenty-nine of malignant tumors,two patient with malignant fibrous histiocytoma received amputation due to local recurrence nine months postoperatively.Ten patients had excellent function,four good and six poor among the followed-up patients.The type of prosthesis in six of all patients with poor function was hinge.Conclusion The custom knee prosthesis replacement was one of the optional methods of limb salvge procedures for distal femur tumors.