Guidelines for Complications of Cancer Treatment Vol VIII Part B

femoral head to the center of the knees. Telemetric studies byTaylor et al 10 have demonstrated that, in a cemented prosthesis,most of the force is transmitted rapidly to the tip of theprosthesis. An increment in offset will increase the bendingmoment around the prosthesis and this may explain the greaterloosening of distal femoral replacements 7,10 .Better surgical technique and the better design ofendoprostheses have reduced complications and improvedthe long-term results. However, either early or latecomplications may occur, including wound necrosis, deepwound infections, joint instability, subluxation or dislocation,joint stiffness, malalignment of patella, fatigue fracture,prosthetic loosening, polyethylene wear, leg lengthdiscrepancy, local recurrence, and soft tissue healing problems.The overall complication rate is between 20-41%, includingmechanical failure (5-16%), dislocation or instability(5-8%),aseptic loosening rate 2-37%, polyethylene wear 2%, localrecurrence(4-11%), wound complication (2-6%), infection (5-15%), neuropraxia 5,7,9,11-25 . The expandable prosthesis hasthe highest complication rate, may be up the 70% 11-12,16,26 .The occurrence of complications may impair the function andquality of life of the patents. The early detection and earlycorrection of minor complications, such as worn polyethylenebushing, resulted in a significant reduction of implant failureand eventual disaster 17 . Thus it may prevent the occurrence ofmajor complications, such as an accelerated process of boneresorption, aseptic loosening, secondary osteoarthritis,fatigue, etc. The necessity of late event of reoperation and attimes amputation also can be avoided.The postoperative complications after endoprostheticreconstruction can occur early or late, or be grouped intoprosthesis-unique or not, however, they are closely related andsome of them are difficult to group. In general, early101