Bilateral Endoprosthetic Replacements of the Proximal Femur

Athanasios F Foukas,Robert J Grimer

doi:10.1080/13577149878163

Abstract

Patient. We report the case of a 20-year-old caucasian male with an Ewing's sarcoma in the left upper femur. After induction chemotherapy, he underwent resection of the left upper femur and insertion of a cemented proximal femoral replacement. Four years later, he presented with a solitary bone metastasis in the right upper femur. He underwent further chemotherapy followed by resection and endoprosthetic replacement of the other proximal femur. He remains disease free with excellent function almost a year after the second operation. Discussion. We believe this is the first reported case of bilateral proximal femoral endoprostheses.

Highlights

Limb-salvage surgery is possible in 85% of patients with primary sarcomas of bone.Re® nements in surgical techniques and chemotherapy regimes mean that patients are living longer and the effectiveness of the limb-salvage surgery and its durability is becoming increasingly important.1± 5 As patients survive longer, unusual patterns of metastatic disease are appearing and these present their own problems in treatmentÐ both surgically and oncologically
We report a case of Ewing’ s sarcoma in which a solitary bone metastasis developed in the contra-lateral proximal fe m ur
Pathological evaluation showed greater than 95% necrosis of the tumour with wide margins of resection

Summary

Introduction

Limb-salvage surgery is possible in 85% of patients with primary sarcomas of bone.Re® nements in surgical techniques and chemotherapy regimes mean that patients are living longer and the effectiveness of the limb-salvage surgery and its durability is becoming increasingly important.1± 5 As patients survive longer, unusual patterns of metastatic disease are appearing and these present their own problems in treatmentÐ both surgically and oncologically. K ey w ords: limb-salvage surgery, end oprosthetic replacement, proximal femur. Limb-salvage surgery is possible in 85% of patients with primary sarcomas of bone. Re® nements in surgical techniques and chemotherapy regimes mean that patients are living longer and the effectiveness of the limb-salvage surgery and its durability is becoming increasingly important.1± 5 As patients survive longer, unusual patterns of metastatic disease are appearing and these present their own problems in treatmentÐ both surgically and oncologically.

Results

Conclusion