[Idiopatic chondrolysis of the hip. Long-term follow-up of a case]. / Condrolisis idiopática de cadera. Evolución a largo plazo.

Idiopathic chondrolysis of the hip is a very rare disease occurring during adolescence. Pain and limp are the most common symptoms and are a consequence of an accelerated loss of the articular cartilage with a lower range of move-ment producing rigidity in the last instance. The natural history is unpredictable and varies between complete and spon-taneous recovery and the ankylosis. The current recommended treatment is conservative, restricting the surgical option for residual stiffness. A clinical case of an eleven year old patient is presented. He consulted for a 2 year, torpid course of left groin pain with limp and rigidity. He received treatment with rest, discharge, analgesics and rehabilitation without any improvement initially. He was treated conservatively with NSAIDS, extremity discharge periods, soft traction in the hospital and at home and rehabilitation, recovering mobility and normal gait 6 years after the beginning of the symptoms. Twelve years after the onset of the symptoms the patient leads a normal life without symptoms and has a symmetric range of motion of both hips.

Condrolisis idiopática de cadera. Evolución a largo plazo / Idiopatic chondrolysis of the hip. Long-term follow-up of a case

La condrolisis idiopática de cadera es una rara condición que se presenta durante la adolescencia. Se caracteriza por dolor y cojera producidos por una pérdida acelerada del cartílago articular con una disminución del grado de movilidad llegando a rigidez. La historia va desde la resolución espontánea completa a la anquilosis. El tratamiento recomendado actualmente es el conservador. Se presenta el caso clínico de un paciente de 11 años de edad con un cuadro clínico de 2 años de evolución tórpida de dolor inguinal izquierdo acompañado de cojera y rigidez. Se instauró reposo, descarga, analgésicos y rehabilitación sin mejoría inicial. Posteriormente recibió tratamiento conservador con AINE, periodos de descarga de la extremidad, tracción blanda hospitalaria, tracción ambulatoria nocturna y rehabilitación, recuperando la movilidad y marcha normal 6 años después del inicio de los síntomas. Catorce años más tarde el paciente hace una vida normal, asintomático y con movilidad simétrica de ambas caderas (AU)

Idiopathic chondrolysis of the hip is a very rare disease occurring during adolescence. Pain and limp are the most common symptoms and are a consequence of an accelerated loss of the articular cartilage with a lower range of movement producing rigidity in the last instance. The natural history is unpredictable and varies between complete and spontaneous recovery and the ankylosis. The current recommended treatment is conservative, restricting the surgical option for residual stiffness. A clinical case of an eleven year old patient is presented. He consulted for a 2 year, torpid course of left groin pain with limp and rigidity. He received treatment with rest, discharge, analgesics and rehabilitation without any improvement initially. He was treated conservatively with NSAIDS, extremity discharge periods, soft traction in the hospital and at home and rehabilitation, recovering mobility and normal gait 6 years after the beginning of the symptoms. Twelve years after the onset of the symptoms the patient leads a normal life without symptoms and has a symmetric range of motion of both hips (AU)

Osteogénesis imperfecta: tratamiento y resultado de una serie de casos / Osteogenesis imperfecta: Treatment and results of a case series

Objetivos: Describir nuestra experiencia en el manejo de los pacientes afectos de osteogénesis imperfecta (OI). Material y métodos: Hemos realizado un estudio retrospectivo de una serie de casos afectos de OI tratados en la Clínica Universidad de Navarra desde 1980 hasta 2007 con un seguimiento medio de 17,3 años (7-27 años). Se han recogido los datos descriptivos, los referentes a las fracturas y a las deformidades observadas y los tratamientos realizados, las complicaciones presentadas y la capacidad funcional al final del seguimiento. Resultados: La muestra revisada consta de 10 pacientes. El 65% de las fracturas sufridas se encontraban en miembros inferiores. Un paciente recibió exclusivamente tratamiento médico. En 3 pacientes se asoció tratamiento médico y quirúrgico. En 6 pacientes se realizó algún tipo de tratamiento quirúrgico. La intervención quirúrgica más frecuente fue la de Sofield-Millar, realizada en 37 ocasiones. Un tercio de estas requirieron cirugía de revisión por migración de los clavos. Se observaron 17 episodios de refractura. Además, se han observado complicaciones como seudoartrosis, fracturas iatrogénicas e infecciones. La funcionalidad al final del seguimiento era de grado I o II según la escala de Hoffer y Bullock en 7 pacientes. Conclusiones: A pesar de la necesidad de múltiples intervenciones y de las complicaciones presentadas durante el seguimiento, el tratamiento adecuado de los pacientes afectos de OI puede proporcionar resultados funcionales aceptables (AU)

Objectives: To describe our experience in the management of patients with osteogenesis imperfect (OI). Material and methods: We conducted a retrospective study of a series of cases affected with OI treated in the Clínica Univesidad de Navarra from 1980 to 2007, with a mean follow up of 17.3 years (7-27 years). We collected descriptive data of the sample, the fractures and the deformities, and the treatments given. The complications presented and the functional outcomes at the end of follow-up were also reviewed. Results: The sample included ten patients. Approximately two-thirds (65%) of fractures were sustained in the lower limbs. One patient received medical treatment only. Three patients had combined medical and surgical treatment. Some type of surgical treatment was performed on 6 patients. The most common surgery was the Sofield-Millar performed on 37 occasions, with a third of them requiring revision surgery due to migration of the nails. There were 17 episodes of re-fracture. Complications such as non-union, iatrogenic fractures, and infections, were also observed. The functional outcome, according to the Hoffer-Bullock scale, at the end of follow-up was grade I / II in 7 patients. Conclusions: Despite the need for multiple interventions and complications presented during follow up, the appropriate treatment of patients with OI can provide acceptable functional outcomes (AU)

[Osteogenesis imperfecta: Treatment and results of a case series]. / Osteogénesis imperfecta: tratamiento y resultado de una serie de casos.

OBJECTIVES: To describe our experience in the management of patients with osteogenesis imperfect (OI). MATERIAL AND METHODS: We conducted a retrospective study of a series of cases affected with OI treated in the Clínica Univesidad de Navarra from 1980 to 2007, with a mean follow up of 17.3 years (7-27 years). We collected descriptive data of the sample, the fractures and the deformities, and the treatments given. The complications presented and the functional outcomes at the end of follow-up were also reviewed. RESULTS: The sample included ten patients. Approximately two-thirds (65%) of fractures were sustained in the lower limbs. One patient received medical treatment only. Three patients had combined medical and surgical treatment. Some type of surgical treatment was performed on 6 patients. The most common surgery was the Sofield-Millar performed on 37 occasions, with a third of them requiring revision surgery due to migration of the nails. There were 17 episodes of re-fracture. Complications such as non-union, iatrogenic fractures, and infections, were also observed. The functional outcome, according to the Hoffer-Bullock scale, at the end of follow-up was grade I/II in 7 patients. CONCLUSIONS: Despite the need for multiple interventions and complications presented during follow up, the appropriate treatment of patients with OI can provide acceptable functional outcomes.

The Burch-Schneider antiprotrusio cage: medium follow-up results.

With the development of hip prosthesis, younger patients may need more than one revision surgery, with less bone stock available in each subsequent surgery. We retrospectively reviewed the hip revision surgeries in which a Burch-Schneider device has been used. Patients were classified according to the Paprosky score. Functional and clinical evaluation was assessed by the Merlé-Daubigné score. Radiolucencies were assessed by Gill's criteria. Sixteen patients with a mean age of 66.1 years were reviewed at a mean follow-up of 60.7 months. According to Paprosky classification, 18.7% were grade IIb, 56.3% grade IIIa and 25% grade IIIb. The mean Merlé-Daubigné score improved from 10 to 15 points. Radiologically, 12 patients had no radiolucencies, two had grade I radiolucencies and two had grade III radiolucencies. In greater than 50% of acetabular defects, the Burch-Schneider seems to be useful providing clinical and functional improvement. Immediately, non-progressive radiolucencies are not associated with implant loosening at the end of follow-up. The ischial flap should be inserted inside the ischial portion of the acetabulum.

Alteraciones morfológicas en la escoliosis. Estudio en raquis humanos en crecimiento / Morphological changes in scoliosis during growth. Study in the human spine

Objetivos. Analizar el sustrato anatomopatológico del raquis escoliótico humano durante el crecimiento. Material y métodos. Estudiamos el raquis, obtenidos en la necropsia, de 2 pacientes afectados de escoliosis. Muestra A (niña de 13 años y 2 meses) y muestra B (niño de 14 años y un mes). Se estudiaron las piezas anatómicas obtenidas en la necropsia. Se realizó un estudio radiológico convencional; se valoró la intensidad de las curvas con los grados de Cobb y la rotación vertebral con el método de Pedriolle, cortes de tomografía computarizada (TC) y análisis de la asimetría posterior (giba). Además, en el estudio histológico se valoró la estructura ósea, los cartílagos de crecimiento, el hueso subcondral, la presencia y la distribución del tejido fibroso. Resultados. Se estudiaron los niveles de C7 a L5 de la muestra A y de T2 a L4 de la muestra B. No se evidenció deformidad de los cuerpos vertebrales en el plano frontal, sagital ni axial, salvo en T5 de la muestra A, con acuñamiento en el plano frontal hacia la convexidad. La deformidad se originaba en los discos intervertebrales. La osificación encondral de los cartílagos epifisarios presentaba una mayor actividad en el lado de la convexidad de la curva. El cartílago neurocentral estaba presente a nivel torácico y cervical, habiendo desaparecido a nivel lumbar. No observamos asimetría en los cartílagos neurocentrales. Conclusiones. La deformidad se inicia en los discos intervertebrales produciéndose alteraciones en los cartílagos epifisarios que pueden condicionar, al final del crecimiento, la deformidad de las vértebras escolióticas, básicamente acuñamiento y rotación (AU)

Objectives. To analyse the pathological substrate of human scoliotic spine during growth. Material and methods. We studied two spines obtained at the autopsy of two patients suffering from untreated scoliosis. Sample A (a girl of 13 years and 2 months) and sample B (a boy of 14 years and one month). On the conventional radiological study the curves were measured using the method of Cobb, and the vertebral rotation with the Pedriolle method. A CT scan and analysis of the posterior asymmetry were also performed. The bone structure, growth plate, subchondral bone were evaluated in the histological study, as well as the presence and distribution of fibrous tissue. Results. Levels from C7 to L5 were studied in sample A, and levels from T2 to L4 in sample B. There was no evidence of vertebral deformity in the frontal, sagittal or axial planes, except for T5 in sample A, where wedging into the concavity in the frontal plane was observed. The deformity originated in the intervertebral discs. Endochondral ossification of the epiphyseal cartilage showed increased activity on the side of the convexity of the curve. Neurocentral cartilage was present at thoracic and cervical level, having disappeared at lumbar level. No asymmetry was observed in the neurocentral cartilage. Conclusions. The deformity begins in the intervertebral discs, producing distortions in the epiphyseal cartilage. Those changes may influence the end of growth and therefore the deformity of the scoliotic vertebrae, basically resulting in wedging and rotation of the vertebrae (AU)

[Morphological changes in scoliosis during growth. Study in the human spine]. / Alteraciones morfológicas en la escoliosis. Estudio en raquis humanos en crecimiento.

OBJECTIVES: To analyse the pathological substrate of human scoliotic spine during growth. MATERIAL AND METHODS: We studied two spines obtained at the autopsy of two patients suffering from untreated scoliosis. Sample A (a girl of 13 years and 2 months) and sample B (a boy of 14 years and one month). On the conventional radiological study the curves were measured using the method of Cobb, and the vertebral rotation with the Pedriolle method. A CT scan and analysis of the posterior asymmetry were also performed. The bone structure, growth plate, subchondral bone were evaluated in the histological study, as well as the presence and distribution of fibrous tissue. RESULTS: Levels from C7 to L5 were studied in sample A, and levels from T2 to L4 in sample B. There was no evidence of vertebral deformity in the frontal, sagittal or axial planes, except for T5 in sample A, where wedging into the concavity in the frontal plane was observed. The deformity originated in the intervertebral discs. Endochondral ossification of the epiphyseal cartilage showed increased activity on the side of the convexity of the curve. Neurocentral cartilage was present at thoracic and cervical level, having disappeared at lumbar level. No asymmetry was observed in the neurocentral cartilage. CONCLUSIONS: The deformity begins in the intervertebral discs, producing distortions in the epiphyseal cartilage. Those changes may influence the end of growth and therefore the deformity of the scoliotic vertebrae, basically resulting in wedging and rotation of the vertebrae.

Rotura bilateral del tendón Aquiles secundario a levofloxacino / Bilateral achilles’ tendon rupture secondary to levofloxacin

Introducción. Las fluoroquinolonas presentan una variedad de efectos secundarios que incluyen la fototoxicidad, las alteraciones dermatológicas y las tendinopatías. Éstas últimas son más frecuentes en tendones que han tenido gran estrés, como el Aquiles, pero su afección bilateral es muy infrecuente. Caso. Presentamos el caso de una paciente de 83 años que al segundo día de tratamiento con levofloxacino comienza con dolor en ambos tendones de Aquiles, que en la valoración clínica y radiológica al mes de iniciados los síntomas se aprecia rotura de ambos tendones, y requiere de tratamiento quirúrgico mediante tenorrafia y colgajos de fascia de gemelos con buena evolución posterior. Conclusiones. Se realiza una revisión de la bibliografía (AU)

Introduction. Fluoroquinolones possess several side effects including phototoxicity, skin alterations and tendinopathies. The latter are more frequent in tendons subjected to heavy stresses such as the Achilles’ tendon. However, bilateral involvement is rare.Clinical case. We present the case of an 83-year-old patient who, 2 days after beginning treatment with levofloxacin developed pain in both Achilles’ tendons. A clinical-radiological assessment one month after the onset of symptoms revealed rupture of both tendons, which made surgical treatment necessary. A tenorrhaphy was performed with gastrocnemius fascial flaps. The patient's evolution was satisfactory. Conclusions. A literature review was performed (AU)

[Influence of the atmospheric pressure and other variable weather on the incidence of the subarachnoid hemorrhage]. / Influencia de los cambios de presión atmosférica y otras variables meteorológicas en la incidencia de la hemorragia subaracnoidea.

UNLABELLED: Spontaneous subarachnoid hemorrhage is a pathology usually related to risk factors, such as arterial hypertension and/or nicotine poisoning. Nevertheless, other variables exist, like meteorological changes, that although the experience aims as possible responsible for an increase of the incidence, are still not established like such. OBJECTIVE: It is to investigate the influence of the meteorological changes, either seasonal variations or changes of atmospheric pressure, in the incidence of the subarachnoid hemorrhage. METHOD: All the cases of spontaneous subarachnoid hemorrhage are considered from the 1st of January from 1997 to the 31st of March of 2008, making a medical registry of demographic aspects (age, sex) and antecedents (arterial hypertension, diabetes mellitus, cerebral ischemia, nicotine poisoning), as well as numbers of atmospheric pressure (in hectopascales, hPa), daily temperature and relative humidity, throughout this period, with a calculation of the maximum, average and minimum values, as well as pressure differentials between consecutive days. RESULTS: The analysis of the 173 gathered cases showed a predominance of the subarachnoid hemorrhage in female, specially the aneurismal ones, being arterial hypertension, the main factor of related risk. Significant differences between the days with and without hemorrhage were not demonstrated, in relation to the variation of atmospheric pressure (p 0.463), pressure temperature (p 0.381) and relative humidity (p 0.595) throughout the day. CONCLUSION: In our element, the variations of atmospheric pressure are not related to an increase of incidence of the subarachnoid hemorrhage. Instead of this, cases of subarachnoid hemorrhage take place with changes of hardly 1.7 (1-3) hPa in the day, without observing a clear seasonal tendency.

Influencia de los cambios de presión atmosférica y otras variables meteorológicas enla incidencia de la hemorragia subaracnoidea / No disponible

La hemorragia subaracnoidea espontánea es unapatología que habitualmente se relaciona con factoresde riesgo, tales como la hipertensión arterial y/o eltabaquismo. Sin embargo, existen otras variables, comolos cambios meteorológicos, que aunque la experienciaapunta como posibles responsables de un aumento de laincidencia, todavía no están establecidas como tales.Objetivo. Investigar la influencia de los cambiosmeteorológicos, ya sean variaciones estacionales ocambios de presión atmosférica, en la incidencia de lahemorragia subaracnoidea.Método. Se consideran todos los casos de hemorragiasubaracnoidea espontánea desde el 1 de enero de 1997al 31 de marzo de 2008, realizando un registro de aspectosdemográficos (edad, sexo) y antecedentes médicos(hipertensión arterial, diabetes mellitus, patologíacerebrovascular, tabaquismo), así como de las cifrasde presión atmosférica (en hectopascales, hPa), temperaturay humedad relativa diarias, a lo largo de dichoperiodo, con un cálculo de los valores máximo, medioy mínimo, así como de las diferencias de presión entredías consecutivos.Resultados. El análisis de los 173 casos recogidosmostró un predominio de la hemorragia subaracnoideaen el sexo femenino, especialmente la de origenaneurismático, siendo la hipertensión arterial, el principalfactor de riesgo relacionado. No se demostrarondiferencias significativas entre los días con y sin hemorragia,en relación a la variación de presión atmosférica(p 0.463), temperatura (p 0.381), humedad relativa (p0.595) a lo largo del día.Conclusión. En nuestro medio las variaciones depresión atmosférica no se relacionan con un aumentode la incidencia de la hemorragia subaracnoidea, produciéndoseésta con cambios de apenas 1,7 (1-3) hPaen el día, sin que se observe una clara tendencia estacional (AU)

Spontaneous subarachnoid hemorrhage is a pathologyusually related to risk factors, such as arterialhypertension and/or nicotine poisoning. Nevertheless,other variables exist, like meteorological changes, thatalthough the experience aims as possible responsible foran increase of the incidence, are still not established likesuch.Objetive. It is to investigate the influence of themeteorological changes, either seasonal variations orchanges of atmospheric pressure, in the incidence of thesubarachnoid hemorrhage.Method. All the cases of spontaneous subarachnoidhemorrhage are considered from the 1th of Januaryfrom 1997 to the 31th of March of 2008, making amedical registry of demographic aspects (age, sex) andantecedents (arterial hypertension, diabetes mellitus,cerebral ischemia, nicotine poisoning), as well as numbersof atmospheric pressure (in hectopascales, hPa),daily temperature and relative humidity, throughoutthis period, with a calculation of the maximum, averageand minimum values, as well as pressure differentialsbetween consecutive days.Results. The analysis of the 173 gathered casesshowed a predominance of the subarachnoid hemorrhagein female, specially the aneurismal ones, beingarterial hypertension, the main factor of related risk.Significant differences between the days with andwithout hemorrhage were not demonstrated, in relationto the variation of atmospheric pressure (p 0,463),pressure temperature (p 0,381) and relative humidity (p0,595) throughout the day (..) (AU)

Recurrencia de la enfermedad de Legg-Calve-Perthes. Caso clínico / No disponible

No disponible

Sarcoma de partes blandas: ¿existe posibilidad de rescate cuando la primera cirugía no fue resolutiva? / Soft tissue sarcoma: can a rescue procedure be performed when the first surgery was unsuccessful?

Objetivo. El objetivo de este trabajo es revisar la experiencia de nuestro centro en el tratamiento de pacientes diagnosticados de sarcoma de partes blandas (SPB) en una extremidad que consultan tras resecciones quirúrgicas inadecuadas o recidiva local. Material y método. Se trata de un estudio retrospectivo de 64 pacientes remitidos tras el tratamiento de un SPB en otro centro, divididos en 2 grupos: el grupo A, compuesto por 27 pacientes a quienes se realizó una escisión inadecuada inicial (whoops procedure) y el grupo B, con 37 pacientes afectos de una recidiva local de un SPB. Se calculó la tasa de supervivencia libre de enfermedad y la tasa de supervivencia acumulada (Kaplan-Meier). Resultados. Grupo A: la totalidad de los 27 pacientes fueron reintervenidos y en 12 casos se detectó enfermedad tumoral residual (un 44%). Veintitrés pacientes recibieron radioterapia asociada (intraoperatoria, braquiterapia y/o externa). El seguimiento medio ha sido de 67 meses (24-216) Tres pacientes presentaron recidiva local, uno de los cuales precisó amputación. El 11% de los pacientes habían fallecido en el momento de la revisión. La tasa de supervivencia libre de enfermedad a los 216 meses ha sido del 85%. Grupo B: 35 de los 37 pacientes fueron reintervenidos (94%). En 21 casos se asoció quimioterapia y en 4 perfusión aislada de la extremidad con factor de necrosis tumoral (TNF) y melfalan (10,8%). Veintisiete pacientes recibieron radioterapia (externa, intraoperatoria y/o braquiterapia) (72%), 19 de ellos habían recibido ya radioterapia después de la primera (70%). En 20 casos (10%) se asoció quimio-terapia y radioterapia. La media de seguimiento ha sido de 80 meses (12-264). Dieciséis pacientes presentaron metástasis después del tratamiento y diecinueve tuvieron complicaciones mayores. El 43% de los pacientes había fallecido en el momento de la revisión. La tasa de supervivencia libre de enfermedad a los 264 meses ha sido del 16%. Conclusiones. Después de una escisión inadecuada inicial se puede obtener una alta tasa de supervivencia libre de enfermedad en pacientes remitidos inmediatamente a centros especializados. Sin embargo, cuando aparece la recidiva local, las posibilidades de supervivencia libre de enfermedad disminuyen drásticamente

Purpose. The purpose of this paper is to review the experience of our hospital in treating patients diagnosed with a soft-tissue sarcoma (STS) in one of their limbs who sought consultation further to inappropriate surgical resections or a local relapse. Materials and methods. This is a retrospective study of 64 patients treated for STS in another hospital; the patients were divided into 2 groups: group A, comprised 27 patients where the initial excision proved to be inappropriate («whoops procedure»); group B was made up of 37 patients that had a local recurrence of a STS. The disease-free and accumulated (Kaplan-Meier) survivorship rates were calculated. Results. Group A: all 27 patients were reoperated and in 12 cases a residual tumoral disease was detected (44%). Twenty-three patients received associated radiotherapy (intraoperatively, brachytherapy and/or external beam radiotherapy). Mean follow up was 67 months (24-216) Three had a local recurrence, two of them requiring amputation. Eleven percent of patients had died at the time of examination. The disease-free survivorship rate at 216 months was 85%. Group B: 35 of the 37 patients were reoperated (94%). Chemotherapy was used in 21 cases and in four cases isolated limb perfusion was used with TNF and melphalan (10.8%). Twenty-seven patients received radiotherapy (external beam, intraoperative and/or brachytherapy) (72%), 19 of them had received radiotherapy after the first one (70%). In 20 cases (10%) both chemotherapy and radiotherapy were used. Mean follow-up was 80 months (range: 12-264). Sixteen patients had metastasis further to treatment and nineteen had major complications. Forty-three percent of patients had died at the time of this review. Disease-free survivorship at 264 months was 16%. Conclusions. After a «whoops procedure» it is possible to obtain a high disease-free survivorship rate in patients referred immediately to specialized units. Nevertheless, when local recurrence occurs, the disease-free survivorship rate decreases sharply

Prótesis total de cadera tras artroplastia de resección / Total hip replacement after resection arthroplasty

Objetivo. Revisar nuestra experiencia en la reconstrucción protésica tras una artroplastia de resección, resultado y posibles complicaciones. Material y método. Estudiamos retrospectivamente 23 caderas reconstruidas tras un período medio de 2,2 años. Fueron criterios de inclusión: presentar una artroplastia de resección, haber sido reconstruido con prótesis articular y que tuvieran un seguimiento mínimo de 1 año. La evaluación se realizó con la escala de Merle D´Aubigne para dolor, marcha y movilidad. Resultados. El alargamiento de la extremidad intervenida fue de 2,9 cm (1,2-4,8). El promedio para dolor fue de 4,6, para movilidad de 4,3 y para la marcha de 5,2. El resultado global fue de 14,1 puntos, considerado aceptable. El 47% presentó resultados buenos o muy buenos. Todos los pacientes mejoraron su capacidad de marcha. Cuatro pacientes presentaron luxación de la prótesis tras la reconstrucción y sólo un paciente presentó reinfección. Conclusiones. La reconstrucción protésica después de una artroplastia de resección es técnicamente difícil, debido al deterioro de las partes blandas y a la alteración, en la cantidad y calidad, de la reserva ósea producto de cirugías previas. La principal ganancia se observó en la capacidad de marcha y menos en el dolor y la movilidad. La selección de los pacientes a reconstruir debe ser cuidadosa para evitar complicaciones y falsas expectativas

Aim. To review our cases of resection arthroplasty in order to determine outcomes and possible complications. Materials and methods. We performed a retrospective study of 23 hips that had undergone reconstruction during the last 2.2 years on average. The inclusion criteria were: resection arthroplasty, joint prosthesis reconstruction, and a minimum followup of 1 year. The Merle D'Aubigne scale was used to assess pain, gait and mobility. Results. Lengthening of the operated limb was 2.9 cm (1.2-4.8). Average scores were: pain 4.6, mobility 4.3 and gait 5.2. The overall result was considered acceptable, with a score of 14.1. Good to very good results were seen in 47% of cases. Gait improved in all patients. Four patients suffered from prosthesis dislocation after reconstruction and only one patient suffered re-infection. Conclusions. Prosthetic reconstruction after resection arthroplasty is technically difficult due to the deterioration of soft tissues and alterations in the quantity and quality of the bone stock due to previous surgeries. The main gain is seen in gait, and to a lesser extent in pain and mobility. Patient selection for reconstruction must be very careful to avoid complications and false expectations