A tumour prosthesis (called sometimes a massive endoprosthesis or a megaprosthesis) is a specialised type of implant used in limb reconstruction surgery to replace a joint together with a large segment of bone. This technology is used after the resection of a tumour or infected bone or in trauma with extensive bone loss. Megaprosthesis allows to restoration of function and mobility in a patient with large bone defects, in case the biological reconstruction of bone and joint is not possible.
Megaprosthesis is typically indicated for severe bone defects too large or not amenable for other reconstructive techniques, it is used in the reconstruction of limb function after the following conditions:
While megaprosthesis is a reasonable solution, there are certain contraindications, including:
The benefits and risks specific to megaprosthesis surgery are:
A number megaprosthesis designs are used to address various bone and joint defects:
Two-stage procedures may be needed to eradicate severe bone infections or address significant deformity before the definitive surgery with megaprosthesis can be employed. Biological Reconstruction can be combined with megaprosthesis implantation where appropriate. Bone grafts, vascularised bone transfers, and bone allografts can be used to increase bone stock around megaprosthesis. Soft Tissue Reconstruction such as muscle flaps or skin grafts or tendon transfers may be performed to provide sufficient coverage and improve functional outcomes.
The choice of surgical option depends on the patient’s specific condition, the location and size of the bone defect, and the surgeon’s expertise. Megaprosthesis implantation requires meticulous planning, precise surgical technique, and thorough post-operative care to achieve optimal outcomes. Whenever possible a specialised megaimplant can replace an extensive bone segment loss, help restore the limb stability, function, and mobility and prevent the need of limb amputation.
If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.
Norwest Private Hospital: (02) 8882 8882
Macquarie University Hospital: (02) 9812 3000