Guidelines for Complications of Cancer Treatment Vol VIII Part B

complications are usually more related to the patient’s status,medical or surgical treatment. The late complications arerelated to the implant or construct or the long-term tissueresponse. The occurrence of complications is related tomultiple factors. They may be related to the poor nutritionaland immune status, lengthy operation, extensive dissectionand resection of soft tissue resulting in an inadequate soft tissuecover, longer exposure of the wound resulting in infection,etc. In addition, the use of a relatively smaller stem due to thesmaller medullary canal in pediatric patients, young and activeindividuals with more activity level, little soft tissue supportor constraint for stability of fixation, wear particle disease dueto larger surface of exposure, higher mechanical stresstransferred to the prosthesis and the prosthesis-bone interfacemay be also encountered in the tumor-endoprostheticreconstruction. All these factors may contribute to either earlyor late complications after endoprosthetic reconstruction. Theimprovement of the surgical technique and chemotherapyprotocols have dramatically decreased the iatrogeniccomplications. Improvement in implant technology havereduced implant specific complications.References1. Myers GJ, Abudu AT, Carter SR, et al. Endoprostheticreplacement of the distal femur for bone tumours: longtermresults. J Bone Joint Surg Br 2007;89B:521–526.2. Sharma S, Turcotte RE, Isler MH, Wong C. Cementedrotating hinge endoprosthesis for limb salvage of distalfemur tumors. Clin Orthop Relat Res 2006; 450:28–32.3. Frink SJ, Rutledge J, Lewis VO, et al. Favorable longtermresults of prosthetic arthroplasty of the knee fordistal femur neoplasms. Clin Orthop Relat Res 2005;438:65–70.102