To explore the complications and management of the prosthesis after the axial knee arthroplasty.

From January 2011 to December 2018, 61 patients who underwent tumor-type axial knee prosthesis replacement at the 980th Hospital (Bethune International Peace Hospital) of the PLA were selected as the research objects. Inclusion criteria: malignant tumors of the lower extremities confirmed by histopathology, good conditions for reconstruction techniques, the patients who were treated with tumor resection, tumor-type axial knee prosthesis replacement, and who received the follow-up. Exclusion criteria: tibial nerve, common peroneal nerve, popliteal artery and vein involvement, or diffusive skin infiltration, the patients with distant metastases, those who did not meet the criteria of extensive resection after systemic chemotherapy, requiring amputation or who was lost to follow-up. Chi-square test or Fisher exact test was performed to analyze the complication incidence in patients with different clinical characteristics in three years.

A total of nine patients had complications in 61 patients within three years after surgery, with an incidence of 14.75%. There was no statistically significant difference in the incidence of complications between different genders(P=0.462), ages(P=0.543), tumor types(P=0.119), Enneking stage(P=0.261), tumor locations(P=0.139), preoperative chemotherapy(P=0.441) and other factors. Among the two patients with prosthesis loosening, , one patient underwent knee prosthesis revision, and one patient was not treated. Two patients with deep infection retained prosthetic debridement surgery combined with postoperative antibiotics for two weeks. One patient with prosthetic fractures underwent tumor prosthetic revision. One patient with periprosthetic fracture underwent open reduction and internal fixation. Among five cases of non-union, three patients healed following iodophor gauze dressing chang, two cases healed following local debridement and dressing change. Two cases encountered common peroneal nerve injury with calf and foot sensation hyperesthesia and partial dysfunction in postoperative one to two months, which were cured after symptomatic treatment.

The complication incidence of prosthesis after tumor-type axial knee arthroplasty is low, and the clinical prevention and treatment can base on the characteristics of complications.