Long-Term Outcomes of Modular Endoprosthesis in Distal Femur Tumor Resection: A Review of Evidence

Abstract

Primary tumors of the distal femur, including osteosarcoma and chondrosarcoma, represent a significant challenge in orthopedic oncology. Limb-salvage surgery with resection and modular endoprosthesis replacement has emerged as the gold standard for preserving function and improving patient outcomes. This review aims to evaluate clinical, functional, and oncological outcomes associated with this surgical approach. A comprehensive review of current literature was conducted, focusing on studies assessing outcomes following distal femoral tumor resection and reconstruction using modular endoprostheses. Key parameters included patient survival, prosthesis longevity, functional scores (e.g., Musculoskeletal Tumor Society [MSTS] score), complication rates, and quality of life post-surgery. The reviewed studies demonstrate favorable long-term outcomes with modular endoprostheses, with 5-year survival rates exceeding 70% in non-metastatic cases. Functional outcomes, as measured by MSTS scores, were generally satisfactory, with most patients achieving independence in daily activities. However, complications such as infection, mechanical failure, and aseptic loosening remain significant concerns, often necessitating revision surgeries. Advances in prosthesis design and surgical techniques have contributed to improved durability and reduced complication rates. Modular endoprosthesis replacement following distal femoral tumor resection offers excellent limb function and survival outcomes in appropriately selected patients. Continued innovation in prosthetic design, surgical expertise, and postoperative care is essential to further reduce complications and optimize long-term results. Future research should focus on comparative studies, long-term follow-up, and patient-reported outcomes to refine treatment strategies.