Megaprosthesis

Megaprostheses may take one of several forms. These include segmental megaprosthesis, which may be used to replace large sections of long bone and often includes an adjacent joint replacement; modular megaprosthesis which allow customisation of available components and custom-made megaprosthesis, where neither segmental or modular options are appropriate. Megaprosthesis implant may also be combined with graft or transfer procedures to improve outcomes.

Preparation prior to surgery

• You will receive a thorough health assessment: including medical history. You may be advised to modify certain lifestyle factors and you may be referred to another specialist. You may be asked to stop taking certain medications as your surgery date approaches. X-rays, CT scans, and MRIs will be used to evaluate your condition and plan your surgery.  
• Skin and bowel preparation: On the evening before your surgery, you will be asked to wash your leg using the sponge provided at your pre-admission clinic. A skin test may be administered if an iodine allergy is suspected. You will also be provided medicine to help you evacuate your bowels prior to surgery.
• Patient education: if neccessary, you may speak with a physiotherapist who can advise you on post-operative mobility. 

On the day of the surgery

• You will be asked to complete your surgical paperwork and will meet with the anaesthetist.
• The surgical site will be prepared.
• You will be administered general or spinal anaesthesia.
• An incision will be made over the target area.
• Dead and damaged bone and soft tissue will be removed.
• An appropriate implant will be fitted and adjunct steps taken to stablise the bone around the implant, as required. Alignment and stability will be confirmed by x-ray.
• Soft tissue will be managed, sometimes with the support of a plastic surgeon.
• Closure: The incision is closed using sutures. A dressing will be applied and vacum assisted wound closure may be used, if appropriate. Your limb may be immobilised. 

After your surgery

• In-patient care: you will remain in hospital for several days for monitoring and early-stage rehabilition. 
• Pain and swelling: You may experience mild to moderate pain. You will be prescribed painkillers to manage these symptoms. Inflammation can be controlled by icing (15 minutes per hour maximum) and elevation.
• Mobilising: you may be fitted with a cast or splint after your surgery. How long it remains in place will be determined by the nature of your procedure and your recovery. You will be unable to weightbear during this period. Once weightbearing is indicated, you can begin gradually, using crutches, boots or brace protection, under clinical supervision. 
• Aftercare: at one week post-surgery, you will be required to attend a wound check and at two weeks your sutures will be removed and further x-rays may be taken. At 6 weeks, you will undergo further X-rays to assess healing, and at three months after your surgery for the same reason. You may be prescribed blood thinners to reduce the risk of a clot developing. 
• Physiotherapy: you recovery will be supported by a tailored physiotherapy protocol.