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Forty-three prostheses with noncemented, high-molecular-weight, polyethylene-sleeved components were used in the treatment of bone tumors around the knee in growing children. The average age of the patients was 11 years. There were 27 boys and 16 girls. There were 17 sleeved components in the distal femur and 26 in the proximal tibia. The average follow-up time was 27 months. The roentgenograms were nominally obtained at three, six, 12, 18, and 24 months, and irregularly thereafter, and were assessed using a zonal evaluation scheme. A sclerotic interface around the polyethylene sleeves invariably developed and progressed in density up to 28 months postoperatively. There were significant zonal differences in sclerosis, particularly between the plateau and the mid-sleeve zone. Only in one patient did a sleeve become loose and require revision.

We report a patient with a peri-acetabular chondrosarcoma which was treated by resection of part of the pelvis and the femoral head. This was followed by replacement with a custom-made titanium alloy pelvic portion and a conventional total hip prosthesis. The operation was carried out in two stages, and yielded a good functional and cosmetic result.

Endoprosthetic replacement of the proximal humerus has been performed in our unit on 25 occasions between 1950 and 1982. The indication for surgery was destruction of the proximal half of the humerus so extensive that the only alternatives were reconstruction or amputation. Of the patients with tumours two died from metastases, and three from unrelated causes; local recurrence necessitated amputation in two patients. Minor complications were frequent, but there were no deep infections and, after 1964, no prosthesis became loose. Active shoulder movement after operation was considerably limited, but passive movement was good and function of the elbow and hand were preserved.

A personal experience is recounted of operations in cases of tumour involving the humerus or femur with restoration by endoprostheses. Twenty-four patients were treated in this way from 1950 to 1969 inclusive and have been followed up for between four and twenty-four years. The patients selected for treatment have presented chondrosarcoma (ten), so-called benign giant-cell tumour of bone, usually recurrent (nine), angiomatous osteolysis (two), seemingly single thyroid or renal metastasis (two), and ununited pathological fracture after irradiation of a tumour (one). Development of the prostheses from early beginnings is outlined. Some points in surgical management are referred to. The complications and results are recorded.