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Maria A. Smolle Department of Orthopaedics and Trauma, Medical University of Graz, Austria

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Dimosthenis Andreou Department of General Orthopaedics and Tumour Orthopaedics, University Hospital Muenster, Germany

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Per-Ulf Tunn Tumour Orthopaedics, HELIOS Klinikum Berlin-Buch, Germany

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Andreas Leithner Department of Orthopaedics and Trauma, Medical University of Graz, Austria

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. Literature research was performed until 10 June 2018. The following search-terms were used to identify studies on advances in tumour endoprostheses: advances tumour endoprostheses, tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND

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Catalin Cirstoiu Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Bogdan Cretu Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Sergiu Iordache Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Mihnea Popa Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Bogdan Serban Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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Adrian Cursaru Orthopedics and Traumatology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Orthopedics and Traumatology Department, University Emergency Hospital Bucharest, Bucharest, Romania

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with this plate that also failed. (B) Intraoperative resected segment and prosthetic measurements. (C) Postoperative X-ray after resection and reconstruction with a long modular fluted stem. Failure of prosthetic fixation may result when tumor

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Daniel Kotrych Department of Orthopedics, Traumatology and Orthopedic Oncology, Pomeranian Medical University, Szczecin, Poland

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Andrea Angelini Department of Orthopedics and Orthopedic Oncology, University of Padova, Italy

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Andrzej Bohatyrewicz Department of Orthopedics, Traumatology and Orthopedic Oncology, Pomeranian Medical University, Szczecin, Poland

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Pietro Ruggieri Department of Orthopedics and Orthopedic Oncology, University of Padova, Italy

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primary malignant bone tumors without compromising the oncological outcome ( 7 , 8 , 9 ). Prosthetic reconstructions after primary bone tumor removal can be divided into two groups based on (i) availability of modular implants or (ii) custom implants for

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Joaquim Soares do Brito Orthopedics Department, University Hospital of Santa Maria, Lisbon, Portugal

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André Spranger Orthopedics Department, University Hospital of Santa Maria, Lisbon, Portugal

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Paulo Almeida Orthopedics Department, University Hospital of Santa Maria, Lisbon, Portugal

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José Portela Orthopedics Department, University Hospital of Santa Maria, Lisbon, Portugal

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Irene Barrientos-Ruiz Orthopedics Department, University Hospital of La Paz, Madrid

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patients (2 cases treated with wide resection and allograft-prosthetic composite; the other case managed only with resection) Yu et al 19 Wide resection (en bloc) and tumoral endoprosthesis (15 hinge knee and 4 rotating-hinge knee) 0.0% 0

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Julie J. Willeumier Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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Yvette M. van der Linden Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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Michiel A.J. van de Sande Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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P.D. Sander Dijkstra Department of Orthopaedics, Leiden University Medical Centre, The Netherlands

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of adjuvant cement. The downsides of using a plate include the large incision needed, a longer surgical procedure and the lack of prophylactic fixation of the entire bone. Prosthetic reconstructions (endoprostheses, segmental prostheses, hemi- and

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Bogdan Cretu Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Bogdan Serban Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Zsombor Panti Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Mihai Nica Carol Davila University of Medicine and Pharmacy, Orthopedics and Traumatology Department, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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complications such as structural failure, peri-prosthetic fracture, aseptic loosening or infection. The APC usually consists of a revision type implant combined with a bone allograft which is the element that presumably improves stability and soft

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Olga D. Savvidou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Panagiotis Koutsouradis Department of Orthopaedic Surgery, 417 Veterans Hospital (NIMTS), Athens, Greece

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George D. Chloros First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Ioannis Papanastasiou First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Thomas Sarlikiotis First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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Aggelos Kaspiris Laboratory of Molecular Pharmacology/ Sector for Bone Research, School of Health Sciences, University of Patras, Patras, Greece

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Panayiotis J. Papagelopoulos First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, ‘ATTIKON’ Hospital, Athens, Greece

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radiation therapy techniques combined with ‘en bloc’ resection of the tumour and various limb salvage procedures and reconstructions with total elbow arthroplasties, megaprostheses, allografts, vascularized autografts, or allograft-prosthetic composite

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Andrea Angelini Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Ivan Bohacek Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Salata, Zagreb, Croatia

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Mihovil Plecko Department of Orthopaedic Surgery, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Salata, Zagreb, Croatia

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Carlo Biz Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Giulia Trovarelli Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Mariachiara Cerchiaro Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Giuseppe Di Rubbo Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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Pietro Ruggieri Department of Orthopedics and Traumatology and Oncological Orthopedics, University of Padova, Italy

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, there are several reconstructive surgical strategies that can be used. Some common strategies include soft tissue reconstructive strategies, massive bone grafting, autografting, free vascularized fibular graft, prosthetic replacement, arthrodesis, and

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Irina-Anca Eremia Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Emergency Medicine, Emergency University Hospital, Bucharest, Romania

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Bogdan Serban Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Orthopaedics and Traumatology, Emergency University Hospital Bucharest, Romania

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Mihnea Popa Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Orthopaedics and Traumatology, Emergency University Hospital Bucharest, Romania

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Adela Iancu Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

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Silvia Nica Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Emergency Medicine, Emergency University Hospital, Bucharest, Romania

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Catalin Cirstoiu Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Department of Orthopaedics and Traumatology, Emergency University Hospital Bucharest, Romania

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not amenable to internal fixation, prostheses are an option. The choice of prosthetic replacement should be robust, targeting vulnerable bone areas to minimize future bone degradation ( 85 ). Prognosis The prognosis of RCC varies considerably

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Bogdan Serban Department of Orthopedics and Traumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Bogdan Cretu Department of Orthopedics and Traumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Adrian Cursaru Department of Orthopedics and Traumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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Cornelia Nitipir Department of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Elias University Emergency Hospital, Bucharest, Romania

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Cristina Orlov-Slavu Department of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Elias University Emergency Hospital, Bucharest, Romania

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Catalin Cirstoiu Department of Orthopedics and Traumatology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
University Emergency Hospital Bucharest, Romania

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the amputation. Radical amputation, however, may alleviate symptoms, with up to 78% relief of pain for patients with symptomatic, debilitating illness. Modern limb prosthetics can enable patients to maintain their independence while restoring a limited

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