Replacement by Ceramic Prostheses for the Treatment of Malignant and Benign Aggressive Bone Tumors

  • Hideki Hayashi
  • Atsumasa Uchida
  • Hideki Hamada
  • Hideki Yoshikawa
  • Yoshitaka Shinto
  • Keiro Ono


Originally, the investigators of limb-salvage operations were mainly concerned with postoperative function. This objective has been realized not only by the progress of prosthetic design, but by the various efforts intended to minimize the resection area [1–5]. The next concern concentrated on two goals: to extend the yardsticks for the indication of the prosthetic replacement for the growing, younger patients and to improve the design of the prosthesis for long-term application, because most of the patients who undergo this type of operation are relatively young. In addition, the loss of bone stock around the prosthesis after longterm use would make any revision surgery more difficult. Several kinds of extending prostheses and temporary resection-arthrodesis were attempted for attaining the first goal [6–9]. Operations employing prostheses with porous-coated stems and anti-micromotion blades, prostheses with porous-coated segments for bone grafts and cement-fixed stems, long-stem prostheses with allografted segments, and ceramic prostheses were performed for achieving the second objective [10–18]. On the other hand, allograft, reimplantation of affected bone with both extracorporeal and intracorporeal irradiation were also carried out because these bones can be permanently used if they could be revascularized and reconstructed with normal bone tissue [19–22]. These methods have another advantage in that they preserve joint cartilage and the attachment of muscle or ligament because these tissues are more resistant against irradiation. However, these methods bear the problem of a high rate of complications, such as infection, fracture, or necrosis [23].


Bone Tumor Proximal Tibia Limb Salvage Proximal Humerus Giant Cell Tumor 
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Copyright information

© Springer Japan 1992

Authors and Affiliations

  • Hideki Hayashi
    • 1
  • Atsumasa Uchida
    • 2
  • Hideki Hamada
    • 3
  • Hideki Yoshikawa
    • 2
  • Yoshitaka Shinto
    • 2
  • Keiro Ono
    • 2
  1. 1.Hayashi HospitalNaka-ku, Hiroshima, 730Japan
  2. 2.Department of Orthopaedic SurgeryOsaka University Medical SchoolJapan
  3. 3.Osaka Prefecture HospitalOsakaJapan

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