Endoprosthetic reconstruction after resection of the tumor of the proximal femur / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the outcome and complications of endoprosthetic reconstruction after wide tumor excision on the patients with neoplasms at the proximal femur.</p><p><b>METHODS</b>Between July 1998 and July 2005, 81 patients with tumor of the proximal femur were treated by wide excision and endoprosthetic reconstruction. Nine cases received devitalized bone and prosthesis composite reconstruction (among them, 3 patients of fibrous dysplasia had long stem bipolar hip replacement) and 5 cases had allograft prosthesis composite replacement. Two cycles of neoadjuvant chemotherapy were given to all the cases of osteosarcoma and Ewing sarcoma. The functional outcomes were evaluated by MSTS 93 score.</p><p><b>RESULTS</b>Among the 30 patients with metastatic tumor, because all of them were transferred to related department to receive chemotherapy or radiotherapy after surgery, the follow-up was not doing well and the rate of local recurrence was not confirmed. Five patients with metastatic tumors died in 3 months after surgery. Most patients had excellent or good function postoperatively, the average MSTS 93 score was 25 in 6 months after surgery. Among the 51 patients with primary tumor, 2 patients had chronic infection and 2 patients had loosening of the prosthesis during the following time. Allograft bone and host bone nonunion were seen in 2 cases. Two patients with bipolar hip replacement had severe acetabulum abrasion. The other 3 patients also received total hip replacement for hip pain after walk. Five patients had local recurrence 6 months to 2 years postoperatively.</p><p><b>CONCLUSIONS</b>Because of low complication rate and good postoperative function, endoprosthetic replacement is a good option for reconstruction of the proximal femur after tumor resection.</p>