it is a benign locally aggressive tumor usually involving the distal end of the femur , proximal tibia and distal radius in young adults . the main variables to be considered for planning treatment include the site of involvement and campanacci stage of the tumor . different treatment options are available which include intralesional curettage , extended curettage , wide resection and reconstruction . functional and oncological outcome of these treatment options varies widely , the predominant detrimental factor being tumor recurrence rate . reconstruction of endoprosthesis after wide excision of the tumor offers good short - term and mid - term functional and oncological outcomes as established by previous studies . this study was conducted to evaluate the long - term outcome of 11 patients with gct who underwent wide excision and customized endoprosthetic replacement . this study included 11 patients ( eight men and three women ) aged 2448 ( mean 32 ) years with primary gct of proximal femur campanacci stage - iii who were available for mean follow - up duration of 10.6 ( range 10.214 ) years . the definite diagnosis was established on histopathological confirmation with incisional biopsy . computed tomography scan of chest and bone scan none of the patients had pulmonary metastasis , and all the 11 patients had a solitary lesion in the proximal femur . these patients underwent wide resection of the tumor using postero - lateral approach to the proximal femur . the proximal femur was reconstructed using a customized , titanium , cemented endoprosthesis [ figure 1 ] . hip abductors , short external rotators and iliopsoas tendon were secured onto the prosthesis and hip capsule repair was performed . postoperative rehabilitation protocol included nonweight bearing and abduction splinting of the limb for 6 weeks followed by nonweight bearing crutch walking for another 6 weeks . once the hip abductors and quadriceps strength was regained weight bearing was allowed . long - term functional outcome was evaluated at minimum 10 years duration using revised musculoskeletal tumor society rating scale . ( a ) radiogragh showing giant cell tumor of proximal femur in a 34-year - old man . ( b ) magnetic resonance imaging showing giant cell tumor of proximal femur with soft tissue extension . there were no instances of prosthesis related complications like aseptic loosening or dislocation . at the end of mean 10.6 years six patients had good hip function without any restrictions , four patients had intermediate functional restriction whereas one had the recreational restriction of function . nine patients enthusiastically accepted the outcome of the procedure whereas two patients had satisfactory emotional acceptance . eight patients were walking without any support with unlimited walking abilities whereas three patients were using a cane for support while walking . the mean is revised musculoskeletal tumor society score was 26.8 out of 30 [ table 1 ] . traditional treatment of gct has been a difficult problem in orthopaedic oncology owing to high recurrence rates following conventional treatment with curettage or extended curettage . ideally treatment currently with improvement in reconstructive surgical techniques and availability of high quality biomechanically designed megaprosthesis , wide resection of tumor with proximal femur endoprosthesis replacement is being considered as a treatment option for campanacci stage - iii lesions in proximal femur with extensive osteolysis and soft tissue extension . it offers good local control of s with least recurrence rate and favorable functional outcome . the previous studies have shown satisfactory short- and mid - term functional and oncological outcomes . this study shows good long - term functional , and oncological outcomes of the procedure and hence the authors recommended as an endoprosthetic replacement for advanced gct of the proximal femur . furthermore , randomized control trials are required to established this modality as a standard treatment .