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Journal of Bone and Joint Surgery - British Volume, Vol 84-B, Issue 3, 401-406.
doi: 10.1302/0301-620X.84B3.12204  
Copyright © 2002 by British Editorial Society of Bone and Joint Surgery
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Revision of the Kotz type of tumour endoprosthesis for the lower limb

F. Mittermayer, MD1; R. Windhager, MD2; M. Dominkus, MD1; P. Krepler, MD1; E. Schwameis, MD1; M. Sluga, MD1; R. Kotz, MD, Head of Department1; and G. Strasser, MD3

1 Department of Orthopaedics
2 Department of Orthopaedics, University of Graz, Auenbruggerplatz 28, A-8036 Graz, Austria.
3 Department of Radiology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.

Correspondence should be sent to Dr F. Mittermayer.

In 251 patients over a period of 15 years an uncemented Kotz modular femoral and tibial reconstruction mega prosthesis was implanted after resection of a malignant tumour of the lower limb. Twenty-one patients (8.4%) underwent revision for aseptic loosening, again using an uncemented prosthesis, and five of these required a further revision procedure. The median follow-up time from the first revision was 60 months (11 to 168) and after a second revision, 33 months (2 to 50). The probability of a patient avoiding aseptic loosening for ten years was 96% for a proximal femoral, 76% for a distal femoral and 85% for a proximal tibial implant.

At the time of follow-up all radiographs were assessed according to the International Symposium of Limb Salvage criteria. The first radiological signs of aseptic loosening were always seen at the most proximal or distal part of the anchorage stem at a mean of 12 months (4 to 23) after the first implantation. Using the Musculoskeletal Tumor Society score for evaluation, the clinical results showed a mean of 88% of normal function.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General