Patient-oriented functional results of total femoral endoprosthetic reconstruction following oncologic resection
✍ Scribed by Kevin B. Jones; Anthony M. Griffin; Coonoor R. Chandrasekar; David Biau; Antoine Babinet; Benjamin Deheshi; Robert S. Bell; Robert J. Grimer; Jay S. Wunder; Peter C. Ferguson
- Book ID
- 102434542
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 86 KB
- Volume
- 104
- Category
- Article
- ISSN
- 0022-4790
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✦ Synopsis
Abstract
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.