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Cemented allograft-prosthesis composite reconstruction for the proximal femur tumor.

Min L, Tang F, Duan H, Zhou Y, Zhang WL, Shi R, Tu CQ - Onco Targets Ther (2015)

Bottom Line: Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%).Eight (32.0%) hips had resorption.There were no cases of recurrence, but metastasis was found in two hips.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

ABSTRACT

Introduction: Cemented allograft-prosthesis composite (APC) reconstruction is one option following resection of the proximal femur tumor. However, rare studies have focused on the indications and complications. The goal of the present study was to (1) ascertain the indications for cemented APC arthroplasty in the proximal femur; (2) identify the detailed perioperative management; and (3) illustrate our experiences to avoid the complications of cemented APC.

Materials and methods: A total 28 patients who underwent cemented APC reconstruction of the proximal femur after tumor resection were retrospectively evaluated at a median follow-up of 56 months. Clinical records and radiographs were reviewed to evaluate patients' outcome.

Results: In our series, excluding three cases of death that had a short follow-up period, union occurred in 22 (88.0%) patients (range 9-18 months). Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%). Eight (32.0%) hips had resorption. There were two (8.0%) hips that were observed to have asymptomatic wear of the acetabulum. The average Musculoskeletal Tumor Society (MSTS) score was 26.5 points. The average Harris Hip Score (HHS) score was 80.6 points. There were no cases of recurrence, but metastasis was found in two hips.

Conclusions: Mastering indications, perioperative management, and complication prevention are all very important in the APC reconstruction after resection of the proximal femur.

No MeSH data available.


Related in: MedlinePlus

The radiograph shows a 6-year postoperative AP of a cemented allograft prosthesis composite for a malignant fibrous histiocytoma before revision.Abbreviation: AP, anterior-posterior X-ray.
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f4-ott-8-2261: The radiograph shows a 6-year postoperative AP of a cemented allograft prosthesis composite for a malignant fibrous histiocytoma before revision.Abbreviation: AP, anterior-posterior X-ray.

Mentions: There were two hips (8.0%) that were observed to have asymptomatic wear of the acetabulum at the follow-up points of 6 years and 8 years. One patient who had a prior revision with extended stem APC revision was severely symptomatic at the follow-up point of 10 years because of progressive wear of the acetabulum and the periprosthetic fracture (Gruen zone III, Vancouver B1), which meant that an additional revision surgery was required (Figures 4, 5). We did revision using extended stem prosthesis and graft implantation (Figure 6). This hip showed good stability at the last follow-up examination.


Cemented allograft-prosthesis composite reconstruction for the proximal femur tumor.

Min L, Tang F, Duan H, Zhou Y, Zhang WL, Shi R, Tu CQ - Onco Targets Ther (2015)

The radiograph shows a 6-year postoperative AP of a cemented allograft prosthesis composite for a malignant fibrous histiocytoma before revision.Abbreviation: AP, anterior-posterior X-ray.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556043&req=5

f4-ott-8-2261: The radiograph shows a 6-year postoperative AP of a cemented allograft prosthesis composite for a malignant fibrous histiocytoma before revision.Abbreviation: AP, anterior-posterior X-ray.
Mentions: There were two hips (8.0%) that were observed to have asymptomatic wear of the acetabulum at the follow-up points of 6 years and 8 years. One patient who had a prior revision with extended stem APC revision was severely symptomatic at the follow-up point of 10 years because of progressive wear of the acetabulum and the periprosthetic fracture (Gruen zone III, Vancouver B1), which meant that an additional revision surgery was required (Figures 4, 5). We did revision using extended stem prosthesis and graft implantation (Figure 6). This hip showed good stability at the last follow-up examination.

Bottom Line: Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%).Eight (32.0%) hips had resorption.There were no cases of recurrence, but metastasis was found in two hips.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

ABSTRACT

Introduction: Cemented allograft-prosthesis composite (APC) reconstruction is one option following resection of the proximal femur tumor. However, rare studies have focused on the indications and complications. The goal of the present study was to (1) ascertain the indications for cemented APC arthroplasty in the proximal femur; (2) identify the detailed perioperative management; and (3) illustrate our experiences to avoid the complications of cemented APC.

Materials and methods: A total 28 patients who underwent cemented APC reconstruction of the proximal femur after tumor resection were retrospectively evaluated at a median follow-up of 56 months. Clinical records and radiographs were reviewed to evaluate patients' outcome.

Results: In our series, excluding three cases of death that had a short follow-up period, union occurred in 22 (88.0%) patients (range 9-18 months). Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%). Eight (32.0%) hips had resorption. There were two (8.0%) hips that were observed to have asymptomatic wear of the acetabulum. The average Musculoskeletal Tumor Society (MSTS) score was 26.5 points. The average Harris Hip Score (HHS) score was 80.6 points. There were no cases of recurrence, but metastasis was found in two hips.

Conclusions: Mastering indications, perioperative management, and complication prevention are all very important in the APC reconstruction after resection of the proximal femur.

No MeSH data available.


Related in: MedlinePlus