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Patient‐oriented functional results of total femoral endoprosthetic reconstruction following oncologic resection
Author(s) -
Jones Kevin B.,
Griffin Anthony M.,
Chandrasekar Coonoor R.,
Biau David,
Babinet Antoine,
Deheshi Benjamin,
Bell Robert S.,
Grimer Robert J.,
Wunder Jay S.,
Ferguson Peter C.
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22003
Subject(s) - medicine , surgery , femur , prospective cohort study , total hip replacement
Background and Objectives Functional outcomes following oncologic total femoral endoprosthetic reconstruction (TFR) are lacking. We compared patient‐oriented functional results of TFRs to proximal femur and distal femur reconstructions (PFR and DFR). We also compared function and complications with regard to knee and hip componentry. Methods Fifty‐four TFR patients were identified from three institutional prospective databases. Forty‐one had fixed‐ and 13 had rotating‐hinge knees, 37 hemiarthroplasty and 17 total hip arthroplasty componentry. Toronto Extremity Salvage Scores (TESS) for n = 27 were compared between groups and to cohorts of PFR (n = 31) and DFR (n = 85) patients using the Mann–Whitney U ‐test. Results Follow‐up averaged 4 years. Mechanical complications included five hip dislocations and one femoral malrotation. Four dislocations were in fixed‐hinge implants, all in those lacking abductor reattachment. TESS averaged 69.3 ± 17.8, statistically decreased from DFR ( P = 0.002) and PFR patients ( P = 0.036). No significant differences were detected between patients in the fixed‐hinge (n = 18) and rotating‐hinge (n = 9) groups ( P = 0.944), or total hip (n = 8) and hemiarthroplasty (n = 19) groups ( P = 0.633). Conclusions TFR is reserved for extreme cases of limb salvage, portending a poor prognosis overall. Function reflects additive impairments from PFR and DFR. TFR outcomes differ little with rotating‐ or fixed‐hinge, total hip or hemiarthroplasty implants. J. Surg. Oncol. 2011; 104:561–565. © 2011 Wiley Periodicals, Inc.