Dr. Öğr. Üyesi Görkem Kıyak
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Fractures & Trauma
Resection of bone with implant replacement
What resection of bone with implant replacement means, when a diseased segment of bone is removed and replaced with a metal endoprosthesis, how it compares with bone grafts, allografts and amputation, approximate costs in Turkey against the UK, US and Germany, the operation step by step, recovery and rehabilitation, the main risks and how to choose an orthopaedic oncology team.
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Resection of bone with implant replacement in Turkey: what it is
Resection of bone with implant replacement is an operation in which a surgeon removes a diseased segment of bone, together with a margin of healthy tissue where needed, and fills the gap with a metal or metal-and-polyethylene implant called an endoprosthesis. The implant restores the length and strength of the limb and, when the removed bone includes a joint such as the knee, hip or shoulder, it replaces the joint as well. The operation belongs to the field of orthopaedic oncology and complex reconstruction and is often described as limb-salvage surgery, because it aims to keep the limb rather than amputate it.
It is used mainly for primary bone tumours such as osteosarcoma, chondrosarcoma, Ewing sarcoma and aggressive giant cell tumours, for bone metastases that have destroyed a segment of bone, for severe bone infection with extensive damage, and for failed earlier joint replacements with large bone loss. This guide covers when it is used, how it compares with other reconstructions, what it costs in Turkey against the UK, US and Germany, the operation, recovery and risks, and how to check a team. For the surgery of the removal itself see our guide to resection of the bone, and for the wider specialty see orthopedics treatments in Turkey.
When is a bone segment removed and replaced with an implant?
The decision starts with a diagnosis, usually from imaging (X-ray, MRI, CT, sometimes a bone scan) and a biopsy that shows what the disease is and whether it has spread. For a bone cancer the aim is to remove all of the tumour with a clear margin; the national bone sarcoma guidance and the NHS describe treatment as a team decision, often with chemotherapy before and after surgery for some tumour types. The implant is chosen when the bone removed is too large to leave a stable, usable limb, when the surrounding muscles, nerves and blood vessels can be saved, and when the patient is fit enough for major surgery. Where cancer has already spread widely, or the limb cannot be made to work, other approaches may be better, and a multidisciplinary tumour board should present them honestly.
Implant, bone graft, allograft or amputation: how do the options compare?
An endoprosthesis is not the only way to fill a gap. A bone graft from the patient (autograft), a donated bone segment (allograft) or a combination may be used, and in some cases the limb is rotated or amputated. A guide to hip or knee options that the same teams use is on our page for total knee replacement, which uses similar implant principles for ordinary joint wear.
| Option | Best suited to | Typical limits |
|---|---|---|
| Metal endoprosthesis (megaprosthesis) | Large segments near the knee, hip, shoulder or long bone shaft; early use of the limb | Implant can loosen, infect or wear; revisions are possible over the years |
| Allograft or autograft reconstruction | Younger patients, shorter defects, where biological healing is wanted | Longer healing before full weight bearing; fracture and non-union risk |
| Amputation or rotationplasty | Tumours that cannot be removed with limb-sparing surgery or after failed reconstruction | Loss of the limb; a prosthetic limb is needed, with adaptation |
The right option depends on the tumour or condition, age, bone quality, the joint involved and your own goals. A team should explain the likely outcome of each rather than steer you to one.
Does it work? What the evidence says
Limb-salvage surgery with endoprosthetic reconstruction is now the standard approach for most bone sarcomas of the limbs when the tumour can be removed with a clear margin. Large studies show that in suitable patients it does not give a worse cancer outcome than amputation, and that most people regain useful function, such as walking with or without a stick. What the evidence also shows is that these implants are not permanent: infection and mechanical problems are more common than in ordinary hip or knee replacements, and a share of patients need further operations over the years. A trustworthy team will talk about the cancer outcome and the implant lifespan separately, and will not promise that the limb will function like a normal one.
Cost of resection of bone with implant replacement in Turkey compared with the UK, US and Germany
The figures below are approximate ranges for the whole admission, not hospital quotes. Each hospital confirms its own price in a written plan after reviewing your scans and biopsy report.
| Country | Approximate cost range |
|---|---|
| Turkey | €9,000 – €40,000 |
| United Kingdom | €22,000 – €65,000 |
| United States | €45,000 – €160,000 |
| Germany | €20,000 – €60,000 |
What changes the resection of bone with implant replacement price: the bone and joint involved, the size of the segment, whether the implant is a modular system from stock or custom-made, whether a 3D-printed or computer-planned guide is used, the length of the hospital stay and any intensive care, blood products, and whether chemotherapy or radiotherapy are part of the plan. A package normally covers pre-operative imaging review, the operation and implant, hospital stay, physiotherapy start and the pathology report; chemotherapy and long-term rehabilitation are often separate and should be priced in writing.
Who is a good candidate, and who is not?
Good candidates are people whose disease is confined to a bone that can be removed with a clear margin, whose nerves and main blood vessels are not involved, who are fit enough for a long operation and who can commit to months of rehabilitation and lifelong follow-up. People with active, uncontrolled infection around the site, with tumours that wrap around major vessels and nerves, or with widespread disease that makes the benefit uncertain, may be advised against it. Age is not a fixed barrier, although growing children need special solutions, for example expandable implants that can be lengthened as they grow. The decision should always follow a full staging work-up and a tumour-board discussion.
How is the operation done, step by step?
- Planning: imaging is reviewed, the margin is planned and, where used, a model or cutting guide is prepared. The implant size and type are chosen.
- Anaesthesia: general anaesthesia, often with a nerve block for pain relief.
- Exposure and resection: the surgeon exposes the bone, protects nerves and vessels and removes the diseased segment with its margin.
- Implant fixation: the endoprosthesis, with its stems fixed in the remaining bone using bone cement or press-fit, is inserted. Muscles and tendons are reattached to the implant, and a joint is reconstructed if included.
- Closure: drains are placed, the wound is closed and, where needed, muscle flaps are used to cover the implant.
The operation can take from three to eight hours depending on the site and complexity. The removed bone goes to the pathologist to confirm that the margins are clear.
Your trip to Turkey and recovery: what are the milestones?
Hospital stay is typically five to fourteen days, and the first days are spent on pain control, drain management and gentle movement under a physiotherapist. Plan to stay in Turkey until the surgeon and physiotherapist agree that the wound has healed and you are safe to travel; that is often two to three weeks for lower-limb operations, sometimes longer, with a medical flight advised for some patients.
| Stage | What to expect |
|---|---|
| Days 1–3 | Pain control, drains, first standing or sitting with a physiotherapist |
| Weeks 1–2 | Wound checks, walking with aids as allowed, stitches or clips removed at about two weeks |
| Weeks 2–6 | Gradual weight bearing if the surgeon allows; strengthening and joint movement exercises |
| Months 3–6 | Walking with less support; return to desk work for many patients |
| After 6 months | Regular scans and clinic checks for years, for both the implant and the underlying disease |
Resection of bone with implant replacement before and after: realistic results
The main result is a limb that is intact, stable and usable instead of one that has lost its bone. X-rays after surgery show the metal implant spanning the gap. Most people walk with a stick or crutch in the early months, and many walk unaided within six to twelve months; high-impact sport, heavy lifting and running are usually discouraged because they stress the implant. Limb length, muscle strength and joint movement may be a little different from the other side, especially if muscles were removed with the tumour. Photographs and scans of patients with a similar tumour site are more useful than general galleries, so ask the team for function outcomes for your specific bone.
Risks and complications
This is major surgery and its risks reflect that. The main concerns are infection, which is higher with large metal implants and may need antibiotics or further surgery; loosening or breakage of the implant over time; dislocation if a joint is replaced; wound healing problems; blood clots in the legs or lungs; nerve or blood-vessel injury; limb length differences; stiffness; and, for cancer, the chance that the disease returns locally or spreads. Chemotherapy brings its own side-effects. Cancer charities and the NHS describe limb-salvage surgery as carrying a significant chance of needing another operation during the person's life. Ask what the team does if the implant becomes infected and who will see you after you fly home.
How to choose a hospital and surgeon, and questions to ask
Look for a hospital where orthopaedic oncology or complex reconstruction is a regular activity, with a multidisciplinary tumour board that includes oncologists, pathologists and radiologists, intensive care, a blood bank, and a physiotherapy and rehabilitation service. Make sure you receive a written plan and price before you pay a deposit. Red flags include a firm price given from a photograph alone, a guarantee that the limb will be saved, no mention of alternatives, no tumour-board review and no aftercare plan abroad. Read how our process works and ask for a plan through our free quote page. Useful questions:
- Has my diagnosis been confirmed by biopsy and discussed by a tumour board?
- Which implant do you plan to use, and is it modular or custom-made?
- How many such operations does the team carry out each year?
- What are the chances of a repeat operation, and what is the plan if the implant is infected?
- How will my own doctors at home be involved in chemotherapy, scans and follow-up?
Hospitals with Orthopedics in Turkey
Frequently asked questions
It is an operation in which a diseased section of bone is removed and replaced with a metal implant called an endoprosthesis, so that the limb keeps its length, strength and, if a joint is included, its movement.
Common reasons are bone tumours, bone metastases that have destroyed a segment, severe bone infection and failed earlier joint replacements with large bone loss. A biopsy and imaging establish the diagnosis first.
For most limb bone sarcomas it is a standard approach and gives most patients a stable, usable limb. The implant is not permanent, and some patients need further operations over the years.
Approximate ranges are €9,000 to €40,000 in Turkey, against about €22,000 to €65,000 in the UK. The price depends on the bone involved, implant type, hospital stay and any chemotherapy; the hospital confirms it in writing.
A stay of about five to fourteen days is typical, depending on the site and complexity. Most patients need physiotherapy before leaving and stay close to the hospital until the wound has healed.
Early walking with aids is usual, with gradual strengthening over three to six months and many patients walking unaided within six to twelve months. Rehabilitation and scans continue for years.
General anaesthesia means you feel nothing during the operation. Pain afterwards is significant in the first days but is managed with nerve blocks and regular medicines, and it usually eases over the following weeks.
Lifespan varies with the site, your activity and whether infection or loosening occurs. Large implants are more likely to need revision than standard joint replacements, so lifelong follow-up is advised.
For suitable tumours, limb salvage with an implant does not give a worse cancer outcome than amputation, and keeps the limb. Amputation may be advised if the tumour cannot be removed with clear margins.
Often two to three weeks for lower-limb operations, including the hospital stay and early rehabilitation, and sometimes longer. Your surgeon decides when it is safe to travel home.
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