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femur 659, proximal tibia 198, proximal femur 145, total femur 25, distal femur and proximaltibia 9. Histology showed 612 osteosarcomas, 113 chondrosarcomas, 72 Ewing’s sarcoma, 31metastatic carcinomas, 89 GCT, 36 MFH,68 other diagnoses.Between1975 and 2006 at Rizzoli 344 reconstructions of the humerus using prosthetic devices (alone orin association with allografts) were performed: 289 MRS®, 37 HMRS®, 2 Osteobridge®, 4composite prostheses, 8 Coonrad-Morrey®, 4 custom made prostheses. Sites of reconstructionwere: proximal humerus 311, distal humerus 19, diaphysis 5, total humerus 9. Histology showed146 osteosarcomas, 56 chondrosarcomas, 23 Ewing’s sarcoma, 67 metastatic carcinomas, 14GCT, 10 MFH, 28 other diagnoses.Patients were followed periodicallyin the clinic. Information were obtained from clinical charts and imaging studies with specialattention to major complications requiring revision surgery. Major prostheses-relatedcomplications were analysed and functional results evaluated according to the MSTS system.Univariate analysis by Kaplan-Meier actuarial curves was used for studying implant survival tomajor complications.Results: Major complications causing implants failure in lower limbs were 80 infections (7.7%), 64 aseptic loosening (6.2%) and 33 breakages (3.2%). In lower limbs infection occurredin 18 KMFTR®, 47 HMRS®, 5 HMRS® Rotating Hinge, 10 GMRS®. Breakage of theprosthetic reconstruction occurred in 16 KMFTR®, 16 HMRS®, 1 HMRS® Rotating Hinge.Aseptic loosening occurred in 15 KMFTR®, 28 HMRS®, 18 HMRS® Rotating Hinge, 3GMRS®. Major complications causing implants failure in upper limbs were 15 infections( 4.3%), 8 aseptic loosening (2.3%) and 4 breakages (1.2%). In upper limbs infection occurredin 14 MRS® and 1 Coonrad-Morrey®. Aseptic loosening in 8 cases MRS®. Breakage in 4cases MRS® prostheses. Most patients in both lower and upper extremities series showedsatisfactory function (good or excellent) according to the MSTS evaluationsystem.Implant survival to allmajor complications of lower limb megaprostheses evaluated with Kaplan-Meier curve was80% at 10 years and 60% at 20 years. Implant survival for the newer designs (GMRS®)available only at middle term follow up showed an implant survival to major complications atabout 90% at 5 years. Implant survival to all major complications was over 80% at 10 years and78% at 20 years.Conclusions: Megaprostheses are the most frequently used type of reconstruction afterresection of the extremities, since they provide good function and a relatively low incidence ofmajor complications. Both function and implant survival improved in the last decades with theintroduction of newer designs and materials.Friday, October 8, 2010, 7:30-8:30Session B9: Complications in ArthroplastyTwo Stage Revision for Infection in Modular Megaprostheses of the LowerLimb After Resection for Bone Tumour*Pietro Ruggieri - University of Bologna, Istituto Rizzoli - Bologna, ItalyElisa Pala - University of Bologna, Istituto Rizzoli - Bologna, ItalyMario Mercuri - University of Bologna - Bologna, Italy*Email: pietro.ruggieri@ior.itfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]