Custom-made endoprostheses for the femoral amputation stump: an alternative to hip disarticulation in tumour surgery

J Bone Joint Surg Br. 2010 Aug;92(8):1134-7. doi: 10.1302/0301-620X.92B8.23682.

Abstract

Disarticulation of the hip in patients with high-grade tumours in the upper thigh results in significant morbidity. In patients with no disease of the proximal soft tissue a femoral stump may be preserved, leaving a fulcrum for movement and weight-bearing. We reviewed nine patients in whom the oncological decision would normally be to disarticulate, but who were treated by implantation of an endoprosthesis in order to create a functioning femoral stump. The surgery was undertaken for chondrosarcoma in four patients, pleomorphic sarcoma in three, osteosarcoma in one and fibrous dysplasia in one. At follow-up at a mean of 80 months (34 to 132), seven patients were alive and free from disease, one had died from lung metastases and another from a myocardial infarction. The mean functional outcome assessment was 50 (musculoskeletal tumor society), 50 and 60 (physical and mental Short-form 36 scores). Implantation of an endoprosthesis into the stump in carefully selected patients allows fitting of an above-knee prosthesis and improves wellbeing and the functional outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amputation Stumps*
  • Amputation, Surgical / methods
  • Combined Modality Therapy
  • Disarticulation
  • Female
  • Femoral Neoplasms / surgery*
  • Femoral Neoplasms / therapy
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Prostheses and Implants*
  • Prosthesis Design
  • Prosthesis Implantation / methods
  • Prosthesis-Related Infections / etiology
  • Retrospective Studies
  • Sarcoma / surgery*
  • Sarcoma / therapy
  • Treatment Outcome
  • Young Adult