Dataset Information

Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure. A prospective population-based study.

ABSTRACT:

Background and objectives

Endoprosthesis is considered a durable implant for treating metastatic bone disease of the proximal femur (MBDf).

Objectives

• What is the revision risk after surgery for MBDf using endoprosthesis versus internal fixation?• When do patients with MBDf treated with endoprosthesis restore quality of life (QoL) and how long time does it take to rehabilitate functional outcome?

Methods

A prospective, population-based, multicentre study of 110 patients. Patients were followed for a minimum of two years after surgery. No patients were lost to implant failure nor survival follow-up.

Results

Forty-four patients were treated with internal fixation and 66 patients received endoprostheses. Two-year implant failure risk for internal fixation was 7% (95CI: 0-14%) versus 2% (95CI: 0-5%) for endoprostheses (p = 0.058).Eq-5D improved to the same level as one month prior to surgery six-weeks after surgery, and the score improved further six months after surgery (median score from 0.603 to 0.694, p = 0.007). MSTS score increased from 12 points after surgery to 23 points six-months after surgery (p<0.001).

Conclusions

Endoprosthesis for treatment of MBDf results in low implant failure rate. Patients are satisfied with the functional outcome. QoL is restored six-weeks after surgery. Authors advocate for caution using internal fixation for MBDf due to findings of a possible high early postoperative revision risk.

SUBMITTER: Sorensen MS

PROVIDER: S-EPMC6911858 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Publications

Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure. A prospective population-based study.

Sørensen Michala Skovlund MS Horstmann Peter Frederik PF Hindsø Klaus K Petersen Michael Mørk MM

Journal of bone oncology 20191022

<h4>Background and objectives</h4>Endoprosthesis is considered a durable implant for treating metastatic bone disease of the proximal femur (MBDf).<h4>Objectives</h4> • What is the revision risk after surgery for MBDf using endoprosthesis versus internal fixation?• When do patients with MBDf treated with endoprosthesis restore quality of life (QoL) and how long time does it take to rehabilitate functional outcome?<h4>Methods</h4>A prospective, population-based, multicentre study of 110 patients ...[more]

PMID: 31871883

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Project description:ObjectiveThe mechanical high modulus structure of the proximal femur could guide clinical surgical treatment and instrument design of proximal femoral fractures. The purpose of this study is to analyze and verify the mechanical structure of the proximal femur.MethodsA total of 375 patients with intertrochanteric fractures were imaged using computed tomography (CT) scans. Patients were grouped according to age and sex. Cortical and medullary cavity parameters (cortical thickness [CTh], cortical mean density [CM], upper-lower diameter length [ULL], and medial-lateral diameter length [MLL]) were measured at eight planes. Six proximal femoral finite element models of different sexes and ages were constructed. To verify the measurement results, Abaqus was used to implement the force load to describe the von Mises stress distribution, and the maximum von Mises stress values of each wall of the proximal femur were compared.ResultsThe CTh values of the lower and upper walls were higher than those of the anterior and posterior walls of the femoral neck (p < 0.05). The CM values of the lower and upper walls were higher than those of the anterior and posterior walls of the subcephalic and middle femoral neck (p < 0.05). The ULL value gradually increased from the subcephalic region to the bottom (p < 0.05). The CTh and CM values of the medial and lateral walls were higher than those of the anterior and posterior walls in the femoral trochanteric region (p < 0.05). The MLL value decreased gradually from the plane 20 mm above the upper edge to that 20 mm below the vertex of the femoral lesser trochanter (p < 0.05). The von Mises stress was concentrated on the upper and lower walls of the femoral neck and on the medial and lateral walls of the femoral trochanteric region. The maximum von Mises stress values of the upper and lower walls were higher than those of the anterior and posterior walls of the femoral neck. The maximum von Mises stress values of the medial and lateral walls were higher than those of the anterior and posterior walls in the femoral trochanteric region, except for the plane 20 mm above the upper edge of the femoral lesser trochanter.ConclusionThe bone mass of the proximal femur presented a triangular high-modulus distribution, which bore the main stress of the proximal femur. The triangular mechanical structure provides a guideline for the surgical strategy and instrument design of the proximal femur.

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Dataset Information

Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure. A prospective population-based study.

Background and objectives

Objectives

Methods

Results

Conclusions

Publications

Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure. A prospective population-based study.

Similar Datasets

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