887 Prosthesis for the treatment of metastatic bone disease of the hip: Effects of radiotherapy

Abstract

Twenty-eight patients with metastatic involvement of the proximal femur were treated by resection and prosthetic replacement. A large femoral prosthetic component was routinely fixed with polymethylmetacrylate bone cement. Radiotherapy was delivered preoperatively in 2 and post-operatively in 7 patients. Postoperative pain (Habermann) was excellent in 81% and good in 15% of the patients. Hip functions (hip rating scale of Merle d’Aubigne) were rated as excellent in 19%, very good in 22% and good in 22% of the hips. Survival correlated with preoperative Karnofsky performance status (P < 0.01) and with the absence of postoperative pulmonary complications (P < 0.01). The radiographs of the 18 patients surviving 3 months or longer showed formation of a new bony envelope around the femoral prosthetic component in 11 cases (61%) and bone remodelling of the distal femur in 12 cases (67%). These changes occurred only if no radiotherapy had been delivered to the femur (P < 0.01). Twenty-eight patients with metastatic involvement of the proximal femur were treated by resection and prosthetic replacement. A large femoral prosthetic component was routinely fixed with polymethylmetacrylate bone cement. Radiotherapy was delivered preoperatively in 2 and post-operatively in 7 patients. Postoperative pain (Habermann) was excellent in 81% and good in 15% of the patients. Hip functions (hip rating scale of Merle d’Aubigne) were rated as excellent in 19%, very good in 22% and good in 22% of the hips. Survival correlated with preoperative Karnofsky performance status (P < 0.01) and with the absence of postoperative pulmonary complications (P < 0.01). The radiographs of the 18 patients surviving 3 months or longer showed formation of a new bony envelope around the femoral prosthetic component in 11 cases (61%) and bone remodelling of the distal femur in 12 cases (67%). These changes occurred only if no radiotherapy had been delivered to the femur (P < 0.01).