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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: 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 endop...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911858/ https://www.ncbi.nlm.nih.gov/pubmed/31871883 http://dx.doi.org/10.1016/j.jbo.2019.100264 |
Sumario: | 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. |
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