Abstract
BackgroundLimb salvage surgery is becoming increasingly popular after tumor resection in the lower extremity. Biological reconstruction and use of megaprosthesis are main methods for malignant bone tumors of the proximal femur, which remain controversial due to short- and long-term complication in the proximal femur. Tumor-bearing bone treated by liquid nitrogen is one of biological reconstruction. This study aimed to evaluate the mid- and long-term functional outcomes and complications in patients treated with frozen autograft–prosthesis composite (FAPC) reconstructions in the proximal femur.MethodsThis retrospective study included 19 patients (10 women, 9 men) with malignant tumors of the proximal femur who underwent tumor-wide resection and FAPC reconstruction (mean age, 46 years; range, 9–77 years). The mean follow-up period of 69 months (range, 9–179 months). Functional outcomes, oncological outcome and complications were evaluated by Musculoskeletal Tumor Society score, clinical and radiological examinations.ResultsThe overall survival rate was 68.4%, and the mean Musculoskeletal Tumor Society functional score was 26.4 points (88%). FAPC survival rates were 100 and 50% at 5 and 10 years, respectively. Five of the 19 patients (26%) had complications: 2 required prosthesis removal and 2 developed a deep infection around acetabular. Wear of the acetabulum occurred in 2 cases, while disease recurrence was occurred in 1 case. There were no cases of greater trochanter avulsion, obvious absorption around frozen bone, prosthesis loosening or leg length discrepancy.ConclusionsDue to without femoral osteotomy, this technique features satisfactory functional outcome and provide biomechanical stability that is comparable to those of other methods of biological reconstruction or megaprosthesis.
Highlights
The proximal femur is a common site of malignant bone tumors, the options for reconstruction after tumor resection are limited due to the requirement of reconstruction of the hip-joint
Megaprosthesis and allograft–prosthesis composite (APC) reconstructions are the most widely used in the proximal femur reconstruction [4, 5]
We focused on the radiological and functional outcomes for frozen autograft–prosthesis composite (FAPC) reconstruction by pedicle freezing in the proximal femur
Summary
The proximal femur is a common site of malignant bone tumors, the options for reconstruction after tumor resection are limited due to the requirement of reconstruction of the hip-joint. The biological and nonbiological reconstructions after malignant tumor resection remain controversial in the proximal femur. Since 1999, we developed a tumorbearing autograft using liquid nitrogen and reported its application for reconstruction in patients with malignant bone tumor [8]. Biological reconstruction and use of megaprosthesis are main methods for malignant bone tumors of the proximal femur, which remain controversial due to short- and long-term complication in the proximal femur. Tumor-bearing bone treated by liquid nitrogen is one of biological reconstruction. This study aimed to evaluate the mid- and longterm functional outcomes and complications in patients treated with frozen autograft–prosthesis composite (FAPC) reconstructions in the proximal femur
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have