Aseptic loosening following Custom Megaprosthesis Reconstruction presenting as a Pseudoarthrosis - A case report

Abstract

IntroductionCustom megaprosthesis reconstruction is a common treatment modality used for the management of large bone defects. Aseptic loosening was found to be the third most common cause of failure of megaprosthesis. Case reportA 40 year old gentleman had recurrent left proximal tibia giant cell tumor. He underwent a resection of the tumor and reconstruction with cemented custom megaprosthesis of the knee. Two years following the surgery, abnormal movement was noted in middle 1/3rd of the leg. Radiographs revealed radiolucency between the tibial component and bone. He was managed conservatively, and the patient continued to mobilise with walker support. ConclusionAseptic loosening can occur isolated in the middle portion of the megaprosthesis tibial component, with an intact tibial stem-bone interface, resulting in a presentation mimicking pseudoarthrosis. The pseudoarthrosis can be managed conservatively unless there is loosening of the entire tibial component and stem.