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Open Access 01-12-2021 | Hip-TEP | Research

Different outcomes after proximal femoral replacement in oncologic and failed revision arthroplasty patients - a retrospective cohort study

Authors: Andreas Toepfer, Veit Straßer, Andreas Ladurner, Anna-Katharina Calek, Primoz Potocnik, Ruediger von Eisenhart-Rothe

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Proximal femoral replacement (PFR) is a technically demanding procedure commonly performed to restore extensive, oncological or non-oncological bone defects in a severely debilitated patient collective. Depending on different indications, a varying outcome has been reported. The aim of the study was to assess the functional outcomes and complication rates of PFR with the modular Munich-Luebeck (MML) femoral megaprosthesis (ESKA/Orthodynamics, Luebeck, Germany), and to highlight outcome differences in patients treated for failed revision total hip arthroplasty (THA) or malignant bone disease.

Methods

A retrospective review of patients treated with PFR for failed THA or malignant tumor disease between 2000 and 2012 was performed. Patient satisfaction, functional outcome (VAS, SF-12, MSTS, WOMAC, TESS), complications and failure types (Henderson’s failure classification) were assessed. A Kaplan-Meier analysis determined implant survival.

Results

Fifty-eight patients (age: 69.9 years, BMI: 26.7 kg/m², mean follow-up: 66 months) were included. The mean SF-12 (physical / mental) was 37.9 / 48.4. MSTS averaged 68% at final follow-up, while mean WOMAC and TESS scored 37.8 and 59.5. TESS and WOMAC scores demonstrated significantly worse outcomes in the revision group (RG) compared to the tumor group (TG). Overall complication rate was 43.1%, and dislocation was the most common complication (27.6%). Implant survival rates were 83% (RG) and 85% (TG; p = n.s.) at 5 years, while 10-year survival was 57% (RG) and 85% (TG, p < 0.05).

Conclusions

PFR is a salvage procedure for restoration of mechanical integrity and limb preservation after extensive bone loss. Complications rates are considerably high.

Functional outcomes and 10-year implant survival rate were worse in the RG compared to the TG. Strict indications and disease-specific patient education are essential in preoperative planning and prognosis.

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Title: Different outcomes after proximal femoral replacement in oncologic and failed revision arthroplasty patients - a retrospective cohort study
Authors: Andreas Toepfer
Veit Straßer
Andreas Ladurner
Anna-Katharina Calek
Primoz Potocnik
Ruediger von Eisenhart-Rothe
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Hip-TEP
Hip-TEP
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-04673-z

At a glance: The STEP trials

Springer Medicine

Different outcomes after proximal femoral replacement in oncologic and failed revision arthroplasty patients - a retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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