Functional outcomes, complications, and survival after endoprosthetic reconstruction for extremity tumours: A large regional cohort analysis from southeast asia.

Authors

Kon Yuen Yi, Vivek Ajit Singh, Rupini Devi Santharalinggam, Nor Faissal Yasin

Published in

Journal of orthopaedic surgery (Hong Kong). Volume 34. Issue 3. Pages 10225536261496572. Epub Oct 08, 2026.

Abstract

BackgroundProsthetic infection is a leading cause of failure in endoprosthetic limb salvage surgery, yet comparative data between limb and pelvic reconstructions are scarce. This study characterises the microbiology, management, and outcomes of postoperative infection in this cohort.MethodsA retrospective study of 39 patients who developed deep prosthetic infection following endoprosthetic reconstruction at a tertiary oncology centre (2007-2024) was conducted. Data included microbiology, surgical management, functional scores (MSTS, TESS), and survival. Descriptive comparisons were made between limb (n=32) and pelvic (n=7) reconstructions.ResultsThere were 220 endoprosthetic replacements during the study period; the infection rate was 17.7%. With a mean follow-up of 82.5 months (range 12-228), infection control was achieved in 79.5% of patients (78.1% of limbs, 85.7% of pelvic reconstructions). Two-stage revision was the most common strategy. Infections were predominantly monomicrobial (74.4%), with Staphylococcus aureus (33.3%) most frequent; antimicrobial-resistant organisms were present in 46.2%. Functional outcomes were superior in limb reconstructions (mean MSTS 67.0%, TESS 71.9%) versus pelvic (mean MSTS 48.7%, TESS 50.2%). The 5- and 10-year overall survival rates were 75.4% and 71.0%, respectively. Metastatic disease was an independent predictor of mortality (HR 12.59, 95% CI 1.47-108.06; p=0.021).ConclusionInfection after endoprosthetic reconstruction necessitates complex management, with satisfactory control achievable in most patients. Functional outcomes are significantly poorer in pelvic reconstructions. Long-term survival is primarily determined by oncological status, particularly metastatic disease.

PMID:
42849882
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

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