Acetabular Erosion After Bipolar Hemiarthroplasty in Proximal Femoral Replacement for Malignant Bone Tumors
Autor: | Marcel-Philipp Henrichs, Georg Gosheger, Tom Schmidt-Bräkling, Burkhard Möllenbeck, Dimosthenis Andreou, Ralf Dieckmann, Christoph Theil |
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Rok vydání: | 2019 |
Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Adolescent Arthroplasty Replacement Hip Bipolar hemiarthroplasty Bone Neoplasms 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Risk Factors medicine Humans Orthopedics and Sports Medicine Femur Aged Retrospective Studies 030222 orthopedics business.industry Acetabulum Middle Aged musculoskeletal system Limb Salvage Surgery Radiography Primary bone Harris Hip Score Radiological weapon Orthopedic surgery Cohort Female Hemiarthroplasty Hip Prosthesis Complication business Total hip arthroplasty |
Zdroj: | The Journal of arthroplasty. 34(11) |
ISSN: | 1532-8406 |
Popis: | Background Hemiarthroplasty megaprosthetic proximal femur reconstruction after tumor resection is a widespread procedure in orthopedic oncology. One potential complication is acetabular wear requiring secondary acetabular revision. The study’s purpose is to investigate prevalence of acetabular erosion, secondary revisions, and potential risk factors. Methods We retrospectively identified 112 patients who underwent proximal femur replacement after resection of a malignant bone tumor and had radiological follow-up longer than 12 months. Patient demographic, surgical, and oncologic factors were recorded, acetabular wear was measured using the classification proposed by Baker, and prosthetic failure was classified using the International Society on Limb Salvage classification. Functional assessment was performed using the Musculoskeletal Tumor Society Score and Harris Hip Score. Results Prevalence of acetabular wear was 28.6%. Secondary conversion to total hip arthroplasty was required in 5 patients (4.6%), all treated for primary bone tumors. No patient treated for metastatic tumor had higher grade acetabular wear or required revision. Significant risk factors for the development of acetabular wear were age under 40 (P = .035) and longer follow-up (63 vs 43 months, P = .004). Other patient, surgical, or adjuvant treatment-related factors were not associated with acetabular revision or acetabular wear. The dislocation rate in the patient cohort was 0.9%. Conclusion Bipolar hemiarthroplasty proximal femoral replacement represents a durable reconstruction after tumor resection. Hip instability is rare. Acetabular erosion is rare and can be successfully treated with conversion to total hip arthroplasty. Young patients with long-term survival over 10 years are at risk. In reconstruction for metastases, instability and acetabular wear are rare. |
Databáze: | OpenAIRE |
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