Endoprosthetic Reconstruction

It is a procedure that involves removing a tumor (usually malignant or benign aggressive) of the bone and replacing it with a metal prosthesis to preserve the limb.

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What is Endoprosthetic Reconstruction?

Limb salvage or limb sparing surgery refers to surgically removing a tumor of an extremity without performing an amputation. The limb is saved. In the past, most sarcomas were treated with an amputation. The most common sarcomas include osteosarcoma, ewing’s sarcoma, and chondrosarcoma. They will predominantly arise in the femur (thigh bone) humerus (long bone of arm), tibia (shinbone), and scapula. Reconstruction of the limb to avoid amputation has become an exciting and groundbreaking moment in the field to restore function and quality of life. Endoprosthetic reconstruction is the surgical procedure performed instead of an amputation and utilizes a metal prosthesis to provide a functional limb. Today, approximately 95% of patients can be treated with a limb sparing surgery instead of an amputation.

Prosthesis Prox Humerus



What’s involved in the technique?

What you can expect afterwards

After your surgery you may spend a few nights in the hospital depending on the type of procedure. Once discharged from the hospital, you will be recuperating at home. Various pain protocols and nerve blocks may be 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. Dr. Wittig usually wants you to keep the same bandages in place that were put on in the OR in a sterile manner and keep the site dry until you return to the office. You will usually return to the office 2 weeks after surgery. 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  commences 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 MRI and X-ray imaging over the course of 5 years to ensure there are no signs of recurrence. You will also likely be monitored for metastases with a CT scan of the chest, abdomen and pelvis. You may, depending on size and grade of the sarcoma, 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 often up to year 10. For the best results, physical therapy protocols should be followed strictly. After radiation and a large surgery, some degree of swelling can be anticipated that could last a lifetime. A proper diet and weight control are imperative to optimize recovery and the ultimate functional result.

Types Of Physical Therapy

Endoprosthetic Reconstruction Video

Dr. James Wittig narrates a video illustrating the surgical technique for an endoprosthetic reconstruction procedure. | WATCH VIDEO