The impact of preoperative bone mineral density on outcomes following lower extremity megaprosthetic reconstruction for oncologic resections

There was no significant difference in revision rate following oncologic lower extremity megaprosthetic reconstruction in patients with or without low BMD. No patients with low BMD in this cohort experienced aseptic loosening or structural failure; however, there was a bias toward cement fixation in patients with low BMD. This may reflect calculated decisions by the surgeon when evaluating the patient's bone quality and their specific risk profile. Our findings suggest that patients with low BMD have similar outcomes to patients without low BMD undergoing oncologic megaprosthetic reconstructions by experienced surgeons. The specific effect of cemented vs uncemented fixation in patients with low BMD in the oncologic population deserves further investigation.