Lower limb proximal amputation for a tumour

Ferrapie, A.-L.; Brunel, Pierre; Besse, Whitney; Altermatt, E.; Bontoux, L.; Richard, Isabelle

doi:10.1080/03093640308726680

Cited by 15 publications

(10 citation statements)

References 10 publications

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“…6 Little is known about activities, participation and experienced limitations in mobility of amputees with hip disarticulation and hemipelvectomy. The literature is restricted to case reports, [7][8][9][10] studies describing hip disarticulation prostheses 2,11 or hip disarticulation prosthetic training, 3,[12][13][14][15][16] and studies reporting energy consumption while walking with a hip disarticulation prosthesis. 4,17 The largest study concerned 41 hemipelvectomy patients.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome of hip disarticulation and hemipelvectomy: a cross-sectional national descriptive study in the Netherlands

2008

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Objective: To describe characteristics of hip disarticulation and hemipelvectomy amputees, to assess their level of activities, participation and experienced limitations in mobility and to describe the amputation-related problems. Design: A cross-sectional study. Setting: Patients were mainly recruited via orthopaedic workshops in the Netherlands. Subjects: Forty-six patients with an acquired unilateral hip disarticulation or hemipelvectomy at least one year post amputation. Main outcome measures: Sickness Impact Profile 68 (SIP 68) to assess the level of activity and participation and the questionnaire Rising and Sitting Down, Walking and Climbing Stairs to assess perceived limitations in mobility. Results: The 46 patients (31 with hip disarticulation and 15 with hemipelvectomy) had a mean age of 55.8 years (SD 12.1). In 78% of cases the reason for amputation was a tumour. Mean SIP 68 was low, 10.5 (SD 6.9). Hip disarticulation amputees had significantly poorer emotional stability than the hemipelvectomy amputees (P = 0.04). All amputees experienced considerable limitations in their mobility according to the Rising and Sitting Down, Walking and Climbing Stairs scores. Conclusions: Hip disarticulation and hemipelvectomy amputees have a relatively high level of activity and participation (SIP scores) but at the same time experience limitations in walking, rising and sitting down and climbing stairs.

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Section: Introductionmentioning

confidence: 99%

Functional outcome of hip disarticulation and hemipelvectomy: a cross-sectional national descriptive study in the Netherlands

2008

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“…Prostheses for patients with disarticulation of the hip or a higherlevel amputation have poor patient compliance. [11][12][13] The patients have difficulty in walking and going up stairs, 14 and expend a great deal more energy walking with the prosthesis than do able-bodied people. 15 Amputees often walk with crutches, leading to painful overloading of the upper limb.…”

Section: Discussionmentioning

confidence: 99%

Custom-made endoprostheses for the femoral amputation stump

Kalson

Gikas

Aston

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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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.

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“…Limb salvage now is considered the standard procedure for treatment of malignant bone tumours in many centres [2,3,6,7,12,10]. According to several authors, dislocation of the endoprosthesis is the most frequent complication [14,15,17].…”

Section: Discussionmentioning

confidence: 99%

Total hip replacement for proximal femoral tumours: our midterm results

Sokolovski

Волошин²,

Aliev

et al. 2006

International Orthopaedics (SICOT)

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Data from 44 patients (23 males, 21 females) with a median age of 39 (range 13-80) years who underwent total hip arthroplasty for proximal femoral tumours (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) were analysed. The histological diagnoses included 14 metastases, six osteosarcomas, six chondrosarcomas, four Ewing's sarcomas, four giant cell tumours, three malignant fibrous histiocytomas, two parosteal and two periosteal osteosarcomas, and one each primary neuroectodermal tumour, myeloid disease, and aneurysmal bone cyst. Twenty-one patients (48%) had pathological fractures. The cause of the pathological fracture was metastasis in 12 patients (57%). Twenty-eight patients (64%) had soft tissue invasion. Complications observed in 17 patients (37%) were local recurrence in two, postoperative haematoma in two, dislocation of prosthesis in five, deep infection in six, and one patient died of myocardial infarction in the early postoperative period. During our midterm survival analysis, functional results were excellent in 25% of patients, good in 57%, fair in 12%, and poor in 6%.Résumé Entre 1994 et 2004, nous avons récolté les données de 44 patients (23 hommes et 21 femmes), dont l'âge moyen était de 39 ans (de 13 à 80), qui ont bénéficié d'une prothèse totale de hanche pour une tumeur de l'extrémité proximale du fémur 4. Le diagnostic étiologi-que a inclus, chez ces patients, 14 métastases, 6 ostéosarcomes, 6 chondrosarcomes, 4 sarcomes d'Ewing, 4 tumeurs à cellules géantes, 4 histiocytomes malins, 2 sarcomes paraosteal, 2 sarcomes périosters et une tumeur neuroectodermique, un myélome un kyste anévrismal. 21 patients (48%) présentaient une fracture pathologique. La fracture pathologique était une métastase chez 12 patients (soit 57%). Pour 28 patients (64%) avaient un envahissement des parties molles. Des complications ont été observées chez 17 patients (37%) avec 2 récidives locales de la tumeur, 2 hématomes post-opératoires, 5 luxations de prothèse, 6 infections profondes et un patient décédé d'infarctus du myocarde en post opératoire précoce. Le résultat fonctionnel a été noté excellent à moyen terme chez 25 patients, bon chez 57%, moyen pour 12% et mauvais pour 6% des patients.

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Lower limb proximal amputation for a tumour

Abstract: Objective: To analyse survival, prosthetic fitting and functional status after trans-femoral amputation or hip disarticulation for a primitive tumour.Methods: Retrospective study of all patients admitted since 1985.

Cited by 15 publications

References 10 publications

Functional outcome of hip disarticulation and hemipelvectomy: a cross-sectional national descriptive study in the Netherlands

Functional outcome of hip disarticulation and hemipelvectomy: a cross-sectional national descriptive study in the Netherlands

Custom-made endoprostheses for the femoral amputation stump

Total hip replacement for proximal femoral tumours: our midterm results

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