{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:07:02Z","timestamp":1789614422276,"version":"build-2803163510"},"reference-count":34,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedics & Traumatology: Surgery & Research"],"published-print":{"date-parts":[[2026,2]]},"DOI":"10.1016\/j.otsr.2025.104527","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T07:56:51Z","timestamp":1761724611000},"page":"104527","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Complications of distal femur megaprostheses"],"prefix":"10.1016","volume":"112","author":[{"given":"Val\u00e9rie","family":"Dumaine","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.otsr.2025.104527_bib0005","doi-asserted-by":"crossref","first-page":"418","DOI":"10.2106\/JBJS.J.00834","article-title":"Failure mode classification for tumor endoprostheses: retrospective review of five institution and a literature review","volume":"93","author":"Henderson","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0010","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.otsr.2019.10.029","article-title":"Fixed-hinge cemented modular implants: an effective reconstruction technique following primary distal femoral bone tumor resection. A 136-case multi-center series","volume":"106","author":"Mattei","year":"2020","journal-title":"Orthop Traumatol Surg Res"},{"issue":"7","key":"10.1016\/j.otsr.2025.104527_bib0015","doi-asserted-by":"crossref","DOI":"10.1016\/j.otsr.2023.103682","article-title":"What to improve : results of fixed-hinge knee endoprosthesis reconstructions over 40 years in a single tumor center","volume":"109","author":"Boukebous","year":"2023","journal-title":"Orthop Traumatol Surg Res."},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0020","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/CORR.0000000000002333","article-title":"What is the long-term survivorship of primary and revision cemented distal femoral replacements for lim salvage of patients with sarcoma","volume":"481","author":"Geiger","year":"2023","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"10.1016\/j.otsr.2025.104527_bib0025","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1097\/CORR.0000000000001106","article-title":"Does a competing risk analysis show differences in the cumulative incidence of revision surgery between patients with oncologic and non-oncologic conditions after distal femur replacement?","volume":"478","author":"Staats","year":"2020","journal-title":"Clin Orthop Relat Res."},{"issue":"17","key":"10.1016\/j.otsr.2025.104527_bib0030","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.2106\/JBJS.19.01022","article-title":"Nonmechanical revision indications portend repeat limb-salvage failure following total femoral replacement","volume":"102","author":"Henderson","year":"2020","journal-title":"J Bone Joint Surg Am."},{"key":"10.1016\/j.otsr.2025.104527_bib0035","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/978-3-540-77960-5_7","article-title":"The long-term risks of infection and amputation with limb salvage surgery using endoprostheses","volume":"179","author":"Jeys","year":"2009","journal-title":"Recent Results Cancer Res"},{"issue":"10","key":"10.1016\/j.otsr.2025.104527_bib0040","first-page":"2225","article-title":"Patellar complications following distal femoral replacement after bone tumor resection","volume":"88","author":"Schwab","year":"2006","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"10.1016\/j.otsr.2025.104527_bib0045","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.arth.2015.09.009","article-title":"Patellar height decreasing after distal femur endoprosthesis reconstruction does not affect functional outcome","volume":"31","author":"Etchebehere","year":"2016","journal-title":"J Arthroplasty."},{"issue":"7","key":"10.1016\/j.otsr.2025.104527_bib0050","doi-asserted-by":"crossref","first-page":"544","DOI":"10.2106\/JBJS.O.00633","article-title":"Patellar resurfacing: does it affect outcomes of distal femoral replacement after distal femoral resection?","volume":"98","author":"Etchebehere","year":"2016","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"10.1016\/j.otsr.2025.104527_bib0055","first-page":"628","article-title":"Complications from the hinged GUEPAR prosthesis after resection of knee tumor. 102 cases","volume":"84","author":"Mascard","year":"1998","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"issue":"4","key":"10.1016\/j.otsr.2025.104527_bib0060","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1302\/0301-620X.89B4.18631","article-title":"Endoprosthetic replacement of the distal femur for bone tumours: long-term results","volume":"89","author":"Myers","year":"2007","journal-title":"J Bone Joint Surg Br."},{"issue":"4","key":"10.1016\/j.otsr.2025.104527_bib0065","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1016\/j.arth.2017.10.051","article-title":"Implant survival and complication profiles of endoprostheses for treating tumor around the knee in adults: a systematic review of the literature over the past 30 years","volume":"33","author":"Haijie","year":"2018","journal-title":"J Arthroplasty."},{"issue":"10","key":"10.1016\/j.otsr.2025.104527_bib0070","first-page":"1981","article-title":"Fractures in bone tumour prosthesis","volume":"39","author":"Piccioli","year":"2015","journal-title":"IntOrthop"},{"issue":"5","key":"10.1016\/j.otsr.2025.104527_bib0075","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1007\/s00264-015-2991-4","article-title":"Megaprostheses in the treatment of periprosthetic fractures of the knee joint: indication, technique, results and review of literature","volume":"40","author":"Windhager","year":"2016","journal-title":"Int Orthop."},{"issue":"1","key":"10.1016\/j.otsr.2025.104527_bib0080","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s43019-020-00034-7","article-title":"Non-neoplastic indications and outcomes of the proximal and distal femur megaprosthesis: a critical review","volume":"32","author":"Vaishya","year":"2020","journal-title":"Knee Surg Relat Res."},{"issue":"2","key":"10.1016\/j.otsr.2025.104527_bib0085","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3390\/cancers14020351","article-title":"Implant survival, clinical outcome and complications of megaprosthetic reconstructions following sarcoma resection","volume":"14","author":"Theil","year":"2022","journal-title":"Cancers (Basel)."},{"issue":"2S","key":"10.1016\/j.otsr.2025.104527_bib0090","first-page":"129","article-title":"Megaprosthesis of the knee in tumor and revision surgery","volume":"88","author":"Pala","year":"2017","journal-title":"Acta Biomed."},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0095","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1007\/s11999-015-4644-8","article-title":"What are the long-term results of MUTARS\u00aeModular endoprostheses for reconstruction of tumor resection of the distal femur and proximal tibia?","volume":"475","author":"Bus","year":"2017","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"10.1016\/j.otsr.2025.104527_bib0100","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s42836-023-00230-2","article-title":"Early radiological outcomes of a fully porous bridging collar in lower-limb endoprosthetic reconstructions: a case-matched retrospective series to assess osseointegration","volume":"6","author":"Stevenson","year":"2024","journal-title":"Arthroplasty."},{"issue":"5","key":"10.1016\/j.otsr.2025.104527_bib0105","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.knee.2011.08.003","article-title":"Long term results of fixed-hinge megaprostheses in limb salvage for malignancy","volume":"19","author":"-Ruggieri","year":"2012","journal-title":"Knee."},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0110","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1002\/jso.24862","article-title":"Long-term outcomes of cement in cement technique for revision endoprosthesis surgery","volume":"117","author":"Bernthal","year":"2018","journal-title":"J Surg Oncol."},{"issue":"11","key":"10.1016\/j.otsr.2025.104527_bib0115","first-page":"234","article-title":"Cortical fenestration for megaprosthesis stem revision","volume":"31","author":"Vincent","year":"2017","journal-title":"EU. Open Orthop J."},{"issue":"9","key":"10.1016\/j.otsr.2025.104527_bib0120","doi-asserted-by":"crossref","first-page":"1851","DOI":"10.1007\/s00264-015-2915-3","article-title":"Peri-prosthetic fractures around tumor endoprostheses: a retrospective analysis of eighteen cases","volume":"39","author":"Barut","year":"2015","journal-title":"Int Orthop."},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0125","article-title":"Diagnosis and management of METS-Stanmore Morse taper failure","volume":"110","author":"Rougereau","year":"2024","journal-title":"Orthop Traumatol Surg Res."},{"issue":"7","key":"10.1016\/j.otsr.2025.104527_bib0130","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1054\/arth.2000.6639","article-title":"Disassembly of a Howmedica modular resection system","volume":"15","author":"Nabeyama","year":"2000","journal-title":"J Arthroplasty."},{"key":"10.1016\/j.otsr.2025.104527_bib0135","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2174\/1874325001711010045","article-title":"Conrad surgical release of severe flexion contracture for oncologic knee arthroplasty","volume":"11","author":"Vincent","year":"2017","journal-title":"EU.Open Orthop J."},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0140","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.rco.2007.10.006","article-title":"Surgical treatment of stiff massive knee endoprosthesis for bone tumors in children and adolescents","volume":"94","author":"Thaunat","year":"2008","journal-title":"Rev Chir Orthop Reparatrice Appar Mot."},{"issue":"6","key":"10.1016\/j.otsr.2025.104527_bib0145","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1302\/0301-620X.98B6.37417","article-title":"Very long-term outcomes after endoprosthetic replacement for malignant tumours of bone","volume":"98-B","author":"Grimer","year":"2016","journal-title":"Bone Joint J."},{"issue":"5","key":"10.1016\/j.otsr.2025.104527_bib0150","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1302\/0301-620X.101B5.BJJ-2018-1106.R1","article-title":"Mechanisms of failure and survival of total femoral endoprosthetic replacements","volume":"101-B","author":"Medellin","year":"2019","journal-title":"Bone Joint J."},{"issue":"6","key":"10.1016\/j.otsr.2025.104527_bib0155","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1007\/s11999-015-4282-1","article-title":"Total femur replacement after tumor resection: limb salvage usually achieved but complications and failures are common","volume":"473","author":"Sevelda","year":"2015","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"10.1016\/j.otsr.2025.104527_bib0160","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/CORR.0000000000002243","article-title":"What are risk factors for and outcomes of late amputation after treatment for lower extremity sarcoma: a childhood cancer survivor study report","volume":"481","author":"Geiger","year":"2023","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"10.1016\/j.otsr.2025.104527_bib0165","doi-asserted-by":"crossref","DOI":"10.1016\/j.otsr.2022.103229","article-title":"What sports activity levels can be achieved in the long-term after major lower extremity amputation for malignant tumors? - A minimum follow-up of twenty years","volume":"108","author":"Hofer","year":"2022","journal-title":"Orthop Traumatol Surg Res."},{"issue":"6","key":"10.1016\/j.otsr.2025.104527_bib0170","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s00590-017-1965-1","article-title":"Radiographic assessment of distal femur cemented stems in tumor endoprostheses","volume":"27","author":"Turcotte","year":"2017","journal-title":"Eur J Orthop Surg Traumatol."}],"container-title":["Orthopaedics & Traumatology: Surgery & Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056825003767?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877056825003767?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T20:09:07Z","timestamp":1770840547000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1877056825003767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["S1877056825003767"],"URL":"https:\/\/doi.org\/10.1016\/j.otsr.2025.104527","relation":{},"ISSN":["1877-0568"],"issn-type":[{"value":"1877-0568","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Complications of distal femur megaprostheses","name":"articletitle","label":"Article Title"},{"value":"Orthopaedics & Traumatology: Surgery & Research","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.otsr.2025.104527","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.rcot.2025.06.013","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Published by Elsevier Masson SAS.","name":"copyright","label":"Copyright"}],"article-number":"104527"}}