Functional Outcome of Custom-Built Fixed Hinged Prosthesis for Tumors around the Knee.


  • Hizbullah Riaz Ansari Resident, Department of Orthopedic and Spine Ghurki Trust Teaching Hospital Lahore
  • Araib Ghega Resident, Department of Orthopedic and Spine Ghurki Trust Teaching Hospital Lahore
  • Majid Zaheer Resident, Department of Orthopedic and Spine Ghurki Trust Teaching Hospital Lahore
  • Ashfaq Ahmed Senior Registrar Department of Orthopedic and Spine, Ghurki Trust Teaching Hospital Lahore
  • Rizwan Akram Professor Department of Orthopedic and Spine Ghurki Trust Teaching Hospital Lahore
  • Atiq uz Zaman Professor Department of Orthopedic and Spine Ghurki Trust Teaching Hospital Lahore
  • Amer Aziz Professor and Head of Department of Orthopedic and spine Ghurki Trust Teaching Hospital Lahore.


Ewing's sarcoma, Fixed hinged, Giant cell tumor,Mega Endoprosthesis, Musculoskeletal Tumor Society (MSTS) Score, Osteosarcoma.


Objective: The determine the functional outcome of custom-built fixed hinged prosthesis for tumors around the knee.

Methods: This descriptive study was conducted in  Department of Orthopedics & Spine Surgery Ghurki Trust Teaching Hospital Lahore from 3rd  January 2015 to 3rd January 2021.All adults patients of either gender and age with tumours of distal femur,proximal tibia or both fulfilling the inclusion criteria were operated for custom-built fixed hinged prosthesis.Post operative functional outcome was determined using Musculoskeletal Tumor Society(MSTS) system and results were graded as excellent(75-100%), moderate (70-74%), Good (60-69%), Fair(50-59%) and  Poor (<50%) outcome.Functional outcome was compared for type of tumor,gender and site of tumour and P value calculated with simple Pearson Chi-Square test.P value<0.05 was considered significant.

Results: A total of 34 patients were included in our study.The mean age was 30.65±14.23 years.Male patients were 23(67.6%) and female 11(32.4%). Osteosarcoma was present in 25(73.5%) patients,Giant cell tumour in 5(14.7%) and Ewing Sarcoma in 4(11.8%). Tumor involvement of  the distal femur was present in 25(73.5%), proximal tibia in 7(20.6%) and both femur and tibia in 2(5.9%) patients. The  mean Musculoskeletal Tumor Society(MSTS) score at 2.5 years was 73%(range 34% to 95%).Excellent functional outcome was noted in 22(64.7%), moderate in 2(5.9%),good in 7(20.6%), fair in 1(2.9%) and poor in 1(2.5%). No significant difference was noted when  functional outcome was compared for gender,type of tumour,stage of tumor,location of tumor, side of tumor and type of stem fixation (P>0.05).

Conclusion: Custom-built fixed hinge prosthesis for tumors around the knee yielded excellent functional results in majority of our patients. We found custom build fixed hinged endoprosthetic reconstruction safe and effective technique for limb salvage in cases of distal femur and proximal tibia tumors.


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How to Cite

Hizbullah Riaz Ansari, Araib Ghega, Majid Zaheer, Ashfaq Ahmed, Rizwan Akram, Atiq uz Zaman, & Amer Aziz. (2021). Functional Outcome of Custom-Built Fixed Hinged Prosthesis for Tumors around the Knee. Journal of Pakistan Orthopaedic Association, 33(03), 95–100. Retrieved from

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