Distal Femur Prosthetic Replacement 

It is a procedure that involves removing a tumor (usually malignant or benign aggressive) of the lower part of the thigh bone (femur) and in most instances replacing the bone and knee joint with a special customizable distal femur tumor prosthesis.

Distal Femur Replacement Xr

What is a Limb-Sparing Surgery of the Lower Leg/Knee?

The knee joint consists of your femur, tibia, fibula, and patella. The distal (lower portion) femur and its diaphysis (middle portion) are common sites for primary bone sarcomas and metastatic tumors.  Some of these tumors include osteosarcomas, chondrosarcomas, and ewing’s sarcomas. Limb-sparing surgery can be performed for approximately 95% of tumors arising from the lower femur. In some instances, the extremity cannot be saved and an amputation is performed. 

Contraindications for saving the limb may include neurovascular invasion, infection, pathological fracture, extensive disease, contamination from a poorly performed biopsy, recurrent disease. 

Distal Femur Prosthesisss



What’s involved in the technique?

What you can expect afterwards

After your surgery you will spend a few nights in the hospital and then will be recuperating at home. Various pain protocols and nerve blocks are used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. You will return to the office 2 weeks after surgery. Patients are usually kept in a knee brace with the knee fully extended for 6 weeks to allow tendon and muscle to heal down to the prosthesis. This is important for the ultimate function of the prosthesis as the biggest difficulty after this surgery is extending the knee completely. After 6 weeks, the muscle and tendon should be healed down to the prosthesi sufficiently to start controlled knee flexion in the brace. You will then proceed to flex the knee 10-20 degrees per week in the brace. You will be advanced 10-20 degrees per week provided you can get your knee straight on your own in the brace. In addition, once cleared, you will subsequently start physical therapy. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.  

You will be monitored periodically with X-rays over the course of 5 years. Sometimes an MRI and/or CT may be used to additionally monitor the area to make sure the tumor has not come back. You will then have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year. Since the bone integrity has been restored to full or almost full, recovery is anticipated provided the patient adheres to strict physical therapy.

Types Of Physical Therapy

Distal Femur Tumor Removal Video

Dr. James Wittig narrates a video illustrating the surgical technique for resection of a sarcoma of the distal femur and reconstruction utilizing a tumor prosthesis. | WATCH VIDEO