The stability of the hip after the use of a proximal femoral endoprosthesis for oncological indications

Henderson, Eric; Keeney, Benjamin J.; Pala, Elisa; Funovics, Philipp T.; Eward, William C.; Groundland, John; Ehrlichman, Lauren K.; Puchner, Stefan; Brigman, Brian E.; Ready, John E.; Temple, H. Thomas; Ruggieri, Pietro; Windhager, Reinhard; Letson, G. Douglas; Hornicek, Francis J.

doi:10.1302/0301-620x.99b4.bjj-2016-0960.r1

Cited by 38 publications

(33 citation statements)

References 48 publications

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“…10 Of note, no capsular repair was not associated with a reduced rate of instability, whilst advanced age, female gender and primary bone tumours were risk factors for instability. 10 The only protective factor against hip instability was a posterolateral approach. 10 Moreover, the authors concluded that a posterolateral approach, together with application of a synthetic device for reconstruction of the soft tissues and a hemiarthroplasty should be best chosen to reduce instability.…”

Section: Resultsmentioning

confidence: 88%

“…The largest study was performed by Henderson et al, comprising 527 patients with proximal femoral arthroplasty for primary bone tumours (benign and malignant) as well as metastases. 10 The authors observed postoperative instability in 20 patients (4.0%), developing after a mean of 35 days. 10 Of note, no capsular repair was not associated with a reduced rate of instability, whilst advanced age, female gender and primary bone tumours were risk factors for instability.…”

Section: Resultsmentioning

confidence: 97%

“…10 The authors observed postoperative instability in 20 patients (4.0%), developing after a mean of 35 days. 10 Of note, no capsular repair was not associated with a reduced rate of instability, whilst advanced age, female gender and primary bone tumours were risk factors for instability. 10 The only protective factor against hip instability was a posterolateral approach.…”

Section: Resultsmentioning

confidence: 97%

“…10 The only protective factor against hip instability was a posterolateral approach. 10 Moreover, the authors concluded that a posterolateral approach, together with application of a synthetic device for reconstruction of the soft tissues and a hemiarthroplasty should be best chosen to reduce instability. 10 Corresponding to this, Du et al investigated hip instability in 58 patients with total femoral replacement for sarcoma.…”

Section: Resultsmentioning

confidence: 99%

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Advances in tumour endoprostheses: a systematic review

et al. 2019

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Tumour endoprostheses have facilitated limb-salvage procedures in primary bone and soft tissue sarcomas, and are increasingly being used in symptomatic metastases of the long bones. The objective of the present review was to analyse articles published over the last three years on tumour endoprostheses and to summarize current knowledge on this topic. The NCBI PubMed webpage was used to identify original articles published between January 2015 and April 2018 in journals with an impact factor in the top 25.9% of the respective category (orthopaedics, multidisciplinary sciences). The following search-terms were used: tumour endoprosthesis, advances tumour endoprosthesis, tumour megaprosthesis, prosthetic reconstruction AND tumour. We identified 347 original articles, of which 53 complied with the abovementioned criteria. Articles were categorized into (1) tumour endoprostheses in the shoulder girdle, (2) tumour endoprostheses in the proximal femur, (3) tumour endoprostheses of the knee region, (4) tumour endoprostheses in the pelvis, (5) (expandable) prostheses in children and (6) long-term results of tumour endoprostheses. The topics of interest covered by the selected studies largely matched with the main research questions stated at a consensus meeting, with survival outcome of orthopaedic implants being the most commonly raised research question. As many studies reported on the risk of deep infections, research in the future should also focus on potential preventive methods in endoprosthetic tumour reconstruction. Cite this article: EFORT Open Rev 2019;4:445-459. DOI: 10.1302/2058-5241.4.180081

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Section: Resultsmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

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Advances in tumour endoprostheses: a systematic review

et al. 2019

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“…Nosso grupo não foi submetido a nenhuma cirurgia além da primária, porém as complicações em reconstruções proximais do fêmur existem e as mais comuns são luxação, instabilidade e infecção (MENENDEZ et al, 2006;HENDERSON et al, 2017). A presente amostra seguiu o padrão relatado pela literatura e foi formada principalmente por pacientes metastáticos (63%)(GUZIK, 2016).…”

Section: Discussão 5 Discussãounclassified

Avaliação funcional retrospectiva de pacientes com tumor ósseo tratados com endoprótese

Prada¹

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Ao Professor Dr. Edgard Eduard Engel por ter ensinado e orientado, com muita calma e paciência. Por ser inspiração como profissional, que cuida e atende com muito carinho cada paciente e que me permitiu vivenciar e participar do Ambulatório de Oncologia Ortopédica (AONO), com sua equipe multiprofissional. Essa experiência me proporcionou muito conhecimento e aprendizado. Ao Professor Dr. Daniel Augusto de Carvalho Maranho, por ter permitido que eu chegasse até aqui. A equipe do Ambulatório de Oncologia Ortopédica, em especial a Amira, por sempre confiar e acreditar no meu trabalho e ao Nelson, por ser, além de educador, uma inspiração no cuidado e atenção ao paciente. Aos meus pais por terem me apoiado, auxiliado e acreditarem nos meus sonhos. Ao meu amado, Carlos, por acreditar em mim, me dar todo apoio, paciência, companheirismo, amizade e amor. Obrigada por todos os dias me fazer feliz! Aos amigos que vivenciaram, torceram e desejaram essa conquista comigo, de perto ou de longe. A cada paciente, que além de ceder seu tempo para que essa pesquisa pudesse ser realizada, trouxeram histórias e ensinamentos para a vida. Vou lembrar de cada um com muito carinho. A CAPES pela bolsa concedida.

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Is osseous reattachment of the greater trochanter necessary compared to soft‐tissue‐only abductor repair in proximal femoral megaprosthesis reconstruction?

Groundland

Jones

et al. 2021

Journal of Surgical Oncology

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Background One of the challenges to surgical reconstruction following oncologic proximal femur resection is reliable re‐establishment of the abductor mechanism. Surgical and functional outcomes following re‐approximation of the abductor mechanism to a metallic endoprosthetic after tumor resection of the proximal femur have not been well established in the literature. Methods A retrospective review was performed, inclusive of patients who received a proximal femur replacement with a metallic endoprosthesis following tumor resection. Patients were divided into two groups: (1) those that received an abductor repair involving a trochanteric osteotomy and osseous fixation of the greater trochanter/abductor mechanism to the endoprosthesis, and (2) those that did not have a trochanteric osteotomy and therefore had an abductor repair consisting of only soft tissue reattachment to the endoprosthesis. The two groups were assessed for demographic characteristics, diagnosis, surgical outcomes including rates of complication and failure, radiographic evidence of trochanteric failure, and functional outcomes. Descriptive statistics, comparative statistics, and logistic regression analyses were performed to discern differences between the two study groups. Results Fifty‐three patients were included in the analysis, 29 had abductor reconstructions involving reattachment of the greater trochanter to the metallic endoprosthesis and 24 had soft tissue reconstruction of the abductor mechanism without bony fixation. There were no differences between the two groups for demographic data, cancer diagnosis, follow up, or survivorship. Radiographic evidence of trochanteric dissociation from the endoprosthesis was observed in 45% of osteotomy cases. Only 10% of patients in the trochanter osteotomy group and 38% of the soft tissue only group were able to resume a normal, non‐Trendelenburg gait at final postoperative visit (p = .024). Need for an assistive ambulatory device was seen in 83% and 67% of the osteotomy and soft‐tissue‐only patients, respectively (p = .21). Conclusion Re‐establishing the abductor mechanism following proximal femur oncologic resection remains a challenge to orthopedic oncologists. Even when possible, salvage of the greater trochanter for reattachment to the endoprosthesis did not lead to improved function in this series, when compared to a similar cohort that received a soft‐tissue‐only abductor repair. Abductor mechanism reconstruction with a greater trochanteric osteotomy and subsequent fixation to the proximal femur endoprosthesis had a high rate of radiographic failure. Additionally, reattachment of the greater trochanter to the proximal femur endoprosthesis demonstrated no improvement in Trendelenburg gait or reliance on an assistive ambulatory device when compared to a soft‐tissue‐only abductor repair.

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The stability of the hip after the use of a proximal femoral endoprosthesis for oncological indications

Cited by 38 publications

References 48 publications

Advances in tumour endoprostheses: a systematic review

Advances in tumour endoprostheses: a systematic review

Avaliação funcional retrospectiva de pacientes com tumor ósseo tratados com endoprótese

Is osseous reattachment of the greater trochanter necessary compared to soft‐tissue‐only abductor repair in proximal femoral megaprosthesis reconstruction?

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