The use of megaprostheses in severe bone loss due to nononcological indications: Three case reports and literature review

Abstract

Reconstruction of severe bone loss and large skeletal defects using biologic materials with autograft or allograft and using tumor endoprostheses (megaprostheses) helped orthopedic surgeons as well as patients in the sparing of limbs. Several types of megaprostheses have been described in the literature for oncological indications with unpredictable outcomes and complication rates. We review single-centered experience of three nononcological cases to assess the safety of using megaprostheses in patients with severe bone loss without malignant disease. In addition, a literature review on the previous use of megaprostheses as treatment modality, their outcome, and complications was done until August 2022. All the participants were found to be good candidates for megaprostheses implants after their refusal of amputation. Their infections were eradicated before the implants, and also, the range of movement and improvements are satisfactory. In addition, according to the literature compared to the alternative of amputation, this operation has proven to be life-altering and revolutionary for many patients. We believe that megaprostheses might be a good limb salvage alternative in patients with significant bone loss and massive skeletal deformities, even in nononcological situations. Future studies should focus on ways to improve the material and design of the megaprostheses and study the long-term complications and survival rate of the implants.