Abstract:

BACKGROUND: Artificial joint prosthesis reconstruction is independent to bone healing, but can restore joint function, relieve pain and rebuilt joint stability. For metastatic tumor proximal to femur, artificial joint prosthesis reconstruction is the best surgical treatment.
OBJECTIVE: To discuss the clinical outcome with endoprosthetic proximal femoral replacement for the patients with metastatic bone disease.
METHODS: A total of 37 cases of metastatic tumor in the proximal femur were treated by wide excision and endoprosthetic proximal femoral replacement, including 20 patients undergoing endoprosthetic reconstruction for pathologic fractures, and others for impending fractures indicated by complains of pain and problems with walking.
RESULTS AND CONCLUSION: The survival time was 2 weeks to 9 years with an average time of 11 months. A total of 32 patients survived for 2-month postoperatively, of them, 14 patients survived for 1 postoperative year. The MSTS function score was 21.68 at the first postoperative year. A total of 8 patients survived after 2 years postoperatively. Of 37 patients, 1 developed deep infection, 2 femoral prosthesis loosening, 1 prosthesis dislocation, 2 abnormal walking due to incomplete abductor strength, 2 limb crispation deformity, and 1 heterotopic ossification. In patients with metastatic disease in the proximal femur, endoprosthetic reconstruction can provide early and stable fixation, remove metastasis with pain reduction and good functional results.