We treated 48 patients with distal femoral tumors by resection and limb salvage with an uncemented megaprosthesis (Howmedica Modular Replacement System). Diagnoses included: 32 osteosarcomas, five chondrosarcomas, six giant cell tumors of the bone, three fibrosarcomas, and two Ewing's sarcomas. The mean follow-up was 5.6 years (2-10 years). The overall complication rate was 39%. Seven patients died of their disease, but none from complications related to the surgery. Five patients were revised to arthrodesis, and one required amputation because of complications. The mean postoperative Musculoskeletal Tumor Society score (MSTS) score was 21 (6-28) for the remaining 35 patients. The most frequent complications were infection (14.6%) and aseptic loosening (4.8%). Ten-year survival of the prosthesis was 65%.

Fifteen patients with proximal femoral tumors had resection and limb salvage with an uncemented Kotz (HMRS) megaprosthesis. There were five osteosarcomas, four chondrosarcomas, one hemangioendothelioma, three fibrosarcomas, and two Ewing's sarcomas. The mean follow-up was 6.7 (range 3-10) years. Two patients died of causes not related to the prosthesis. The postoperative Musculoskeletal Tumor Society score (MSTS) score was 19 (range 12-26) for the remaining 13 patients. There were one aseptic loosening, two infections, and one local recurrence. The most frequent complication was hip dislocation at 20%. Reconstruction of proximal femoral tumors with a modular megaprosthesis is a good procedure, but hip instability remains a major problem.Résumé Nous avons opéré 15 patients porteurs de tumeur maligne du fémur proximal par résection et reconstruction avec une mégaprothese du type Kotz. Il y avait 5 ostéosar-comes, 4 chondrosarcomes, une hemangioendothelioma, 3 fibrosarcomes et 2 sarcomes d'Ewing. La suivie moyenne fut 6.7 ans (entre 3 et 10 ans). Deux patients sont décédés de causes sans relation avec la prothèse. Le score de la société des tumeurs musculo-skelettiques américaine fut 19 en moyenne (de 12 a 26) pour les 13 autres patients. Nous avons noté un descellement aseptique, deux infections et une récidive locale. La complication la plus fréquente fut la luxation chez 3 malades, donc 20%. La reconstruction après résection d'une tumeur du fémur proximal par une mégaprothese modulaire est une bonne méthode, mais l'instabilité de la hanche reste un problème majeur.