Internal fixation versus endoprosthetic replacement of the proximal femur for metastatic bone disease: Single institutional outcomes

Abstract

PurposeThis study compared internal fixation (IF) to proximal femur replacement (PFR) for proximal femoral metastasis. MethodsBetween 2005 and 2019, 113 lesions underwent IF (n = 94) or PFR (n = 19). Revision risk was calculated with mortality as a competing event. ResultsThe 5-year revision risk after IF was 17.6% (95% CI, 9.8%–27.3%) compared to 7.6% (95% CI, 0.3%–28.9%) after PFR (p = 0.59). PFR had longer operative times (p < 0.001), hospital stay (p = 0.039), and higher blood loss (p < 0.001) than IF, respectively. ConclusionsIF may be considered for patients with poor health and a limited prognosis given the less-invasive procedure and shorter hospital stay. Level of evidenceIII. Retrospective Study;