SHORTAND MIDDLE-TERM RESULTS OF HIP ARTHROPLASTY FOR TUMORS OF THE PROXIMAL FEMUR

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Abstract

A purpose of the study was to evaluate the immediate and medium-term outcomes of the treatment of patients with primary tumor lesions of proximal femur after the lesion resection together with total hip arthroplastyby total revision systems. Material and methods. 34 patients with primary tumors of proximal femur [chondrosarcoma - 9 (26.5%),giant cell tumor - II (32.4%),osteosarcoma - 2 (5.8%), other malignancies - 5 (14.7%),benign neoplasms - 7 (20.6%)] underwent the conserving surgery at R.R. Vreden Russian Research Institute of Traumatology and Orthopedics since 2003 through 2013. The follow-up was from one to five years. The age of patients ranged from 16 to 70 years, patients younger than 40 years accounted for 61.8%. Acetabulum was replaced by standard components. To replace post-resection defects of proximal femur, in 21 (61.8%) patents revision legs of cementless fixation Wagner Revision (Zimmer) were used, in 10 (29.4%) - “Fenix”, and in 3 (8.8%) - Solution (DePuy, J&J). Results. A technique of total hip arthroplasty with the use of revision systems demonstrated excellent and positive results in 32 (94.2%) cases. Complications leading to revision surgery occurred in 3 (8.8%) patients. Conclusion. The method allows achievement of favorable functional outcomes and early patients’ activation without worsening the oncologic component of treatment and being not inferior to expensive modular systems.

About the authors

R. M. Tikhilov

Vreden Russian Research Institute of Traumatology and Orthopedics; Mechnikov Northwestern State Medical University

Author for correspondence.
Email: info@rniito.org
Russian Federation

D. A. Ptashnikov

Vreden Russian Research Institute of Traumatology and Orthopedics; Mechnikov Northwestern State Medical University

Email: drptashnicov@yandex.ru
Russian Federation

P. J. Zasulskiy

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: zph1966@yandex.ru
Russian Federation

I. M. Mikailov

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: mim17@mail.ru
Russian Federation

P. V. Grigoriev

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: maddoc_pvg@mail.ru
Russian Federation

D. G. Pliev

Vreden Russian Research Institute of Traumatology and Orthopedics

Email: plievd@gmail.com
Russian Federation

References

  1. Алиев М.Д., Соколовский В.А., Дзампаев А.З., Нисиченко Д.В., Сергеев П.С., Хестанов Д.Б. Отдаленные результаты применения мегапротезов в хирургии опухолей костей и суставов. Вестник московского онкологического общества [Internet]. 2011; (4). Режим доступа www.netoncology.ru/press/1191/
  2. Алиев М.Д. Эндопротезирование как основа онкоортопедии. Поволжский онкологический вестник. 2012 (2): 14-20
  3. Засульский Ф.Ю., Куляба Т.А., Пташников Д.А., Григорьев П.В., Микайлов И.М. Анализ осложнений после эндопротезирования коленного сустава по поводу опухолевых поражений (20-летний опыт). Травматология и ортопедия России. 2013 (4): 24-32
  4. Миронов С.П. Рентгенодиагностика первичных опухолей и опухолеподобных заболеваний. М.: Новости; 2004. 247 с
  5. Тепляков В.В., Карпенко В.Ю., Франк Г.А., Буланов А.А., Державин В.А., Шаталов А.М. Эндопротезирование при опухолевом поражении длинных костей. Российский онкологический журнал. 2009; (5): 11-14
  6. Тепляков В.В., Карпенко В.Ю., Шаталов А.М., Бухаров В.А., Державин В.А., Мысливцев И.В. Эндопротезирование длинных трубчатых костей и суставов при дефиците мягких тканей. Вестник московского онкологического общества [Internet]. 2011; (4). Режим доступа: www.netoncology.ru/press/1191/
  7. Тихилов Р.М., Засульский Ф.Ю., Григорьев П.В., Савчук А.В., Плиев Д.Г. Эндопротезирование тазобедренного сустава при метастатическом поражении проксимального отдела бедренной кости (медицинская технология). СПб.; 2011. 24 с
  8. Шугабейкер П.Х., Малауэр М. М. Хирургия сарком мягких тканей и костей. Принципы и оперативная техника. М.: Медицина; 1986. 439 с
  9. Anderson M.E., Hyodo A., Zehr R.J., Marks K.E., Muschler G.F. Abductor reattachment with a custom proximal femoral replacement prosthesis. Orthopedics. 2002. 25:722-726.
  10. Dominkus M., Sabeti M., Kotz R. Functional tendon repair in orthopedic tumor surgery. Orthopäde, 2005; 34 (6):556-559.
  11. Donati D., Zavatta M., Gozzi E., Giacomini S., Campanacci L., Mercuri M. Modular prosthetic replacement of the proximal femur after resection of a bone tumor a long-term follow-up. J. Bone Joint Surg. Br. 2001. 83:1156-1160.
  12. Henderson E.R. et al. Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review. J. Bone Joint Surg. Am. 2011;93(5):418-429.
  13. Gosheger G., Gebert C., Ahrens H., Streitbuerger A., Winkelmann W., Hardes J. Endoprosthetic reconstruction in 250 patients with sarcoma. Clin. Orthop. 2006; (450):164-171.
  14. Kabukcuoglu Y., Grimer R.J., Tillman R.M., Carter S.R. Endoprosthetic replacement for primary malignant tumors of the proximal femur. Clin. Orthop. 1999; (358):8-14.
  15. Kawai A., Backus S.I., Otis J.C., Inoue H., Healey J.H. Gait characteristics of patients after proximal femoral replacement for malignant bone tumour. J. Bone Joint Surg. Br. 2000; 82:666-669.
  16. Kotz R. Tumor endoprosthesis in malignant bone tumors. Orthopäde. 1993; 22 (3): 160-166.
  17. Ogilvie C.M., Wunder J.S., Ferguson P.C., Griffin A.M., Bell R.S. Functional outcome of endoprosthetic proximal femoral replacement. Clin. Orthop. 2004; 426:44-48.
  18. Orlic D., Smerdelj M., Kolundzic R., Lower M. Limb salvage surgery: modular endoprosthesis in bone tumour treatment. Bergovec Int. Orthop. 2006; 30(6): 458-464.
  19. Scharf S., Zhao Q.H. Radionuclide bone scanning in routine clinical practice. Lippincotts Prim. Care Pract. 1999; 3 (5): 521-528.
  20. Schneiderbauer M.M., Sierra R.J., Schleck C., Harmsen W.S., Scully S.P. Dislocation rate after hip hemiarthroplasty in patients with tumor-related conditions. J. Bone Joint Surg. Am. 2005; 87:1810-1815.
  21. Uchida A. Recent advances in management of musculoskeletal tumors. Gan To Kagaku Ryoho. 1999; 26: 185-190.
  22. Ward W.G., Johnston K.S., Dorey F.J., Eckardt J.J. Loosening of massive proximal femoral cemented endoprostheses. Radiographic evidence of loosening mechanism. J. Arthroplasty. 1997; 12:741-750.

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