Evidence map›Paper›PMID 40857599›Full record

ArticleSICOT-J2025

Implant survival and risk factors for failure after proximal femoral megaprosthetic reconstruction.

Anastasios G Roustemis, Panayiotis Gavriil, Stavros Goumenos, Ioannis Trikoupis, Vasileios Karampikas, Panagiotis Koulouvaris, Vasileios Kontogeorgakos, Olga Savvidou, Andreas F Mavrogenis, Panayiotis J Papagelopoulos

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Article in SICOT-J, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Proximal femoral replacement for oncologic and non-oncologic indications: a retrospective study over a 13-year period.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Anastasios G RoustemisFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.ORCID 0000-0003-1685-5559
Panayiotis GavriilFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.
Stavros GoumenosDepartment of Orthopaedics, Charité - Universitätsmedizin Berlin, 20 Schumannstraße, 10117 Berlin, Germany.
Ioannis TrikoupisThe Royal Orthopaedic Hospital NHS Foundation Trust, Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, United Kingdom.
Vasileios KarampikasFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.
Panagiotis KoulouvarisFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.
Vasileios KontogeorgakosFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.
Olga SavvidouFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.
Andreas F MavrogenisFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.
Panayiotis J PapagelopoulosFirst Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Rimini Street, Chaidari 124 62, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProximal femoral megaprosthetic reconstruction is a well-established solution for extensive bone loss in the hip region. Despite its utility in limb salvage, it carries notable complication rates, reported between 30% and 40%, along with increased morbidity and mortality. This study evaluated implant and patient survival, failure modes, and associated risk factors.

methodsWe retrospectively reviewed 165 patients who underwent proximal femoral megaprosthetic reconstruction between 2003 and 2023. Indications included primary bone tumors (n = 67), metastatic bone disease (n = 60), and non-oncologic conditions (n = 38). A total of 57 METS (Stanmore) and 108 MUTARS (Implantcast) implants were used. Median follow-up was 5 years (range: 0.25-17 years).

resultsMean implant survival was 5.13 years (range: 0.2-17 years), with an overall complication rate of 30.9%. The most common failure modes were type 1 (11.5%) and type 4 (13.3%) per Henderson classification. Five-year implant survival ranged from 60% to 70% across indications. Independent risk factors for type 4 failure included prolonged hospitalization (OR = 1.07, p = 0.020) and longer operative time (OR = 1.01, p = 0.023). Silver-coated implants showed a trend toward reduced infection (OR = 0.18, p = 0.29), though not statistically significant. METS implants were associated with lower type 1 failure risk (OR = 0.09, p = 0.020), with a soft-tissue failure rate of 3.5% versus 15.7% for MUTARS.

conclusionProximal femoral megaprostheses remain effective for limb salvage but are linked to a substantial complication burden. Recognition of modifiable and patient-specific risk factors may improve surgical outcomes and reduce failure rates.

Indexed as

ComplicationsLimb salvageProximal femoral megaprosthetic reconstructionRisk factorsSurvival

Identifiers

PMID40857599
PMCPMC12380411

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.