Proximal femoral reconstruction with custom mega prosthesis

Area of Science:

• Orthopedic Surgery
• Oncology
• Biomedical Engineering

Background:

• Proximal femoral tumors pose significant challenges for limb preservation.
• Limb salvage surgery with custom mega prostheses offers a reconstructive option.
• Evaluating outcomes of this complex surgical approach is crucial.

Purpose of the Study:

• To assess the oncological and functional outcomes of limb salvage surgery for proximal femoral tumors using custom mega prostheses.
• To identify the types of complications associated with this surgical technique.
• To determine the long-term efficacy of custom mega prostheses in managing proximal femoral bone tumors.

Main Methods:

• Retrospective review of 44 patients with proximal femoral tumors treated between July 1989 and January 2002.
• Surgical procedures included limb salvage with custom mega prostheses.
• Analysis of oncological outcomes (margins, survival) and functional results, along with complication rates.

Main Results:

• Forty-one patients had malignant neoplasms, including giant cell tumors, chondrosarcoma, and metastases.
• Wide margins were achieved for malignant tumors; marginal resection for benign/metastatic lesions.
• Satisfactory functional activity was reported in 79% of patients, with mechanical complications (fracture) in 6 cases and oncological complications in 5 patients.

Conclusions:

• Limb salvage surgery with custom mega prostheses provides a viable option for proximal femoral tumors, achieving good functional outcomes.
• Careful surgical planning and execution are essential to minimize both mechanical and oncological complications.
• This reconstructive technique demonstrates acceptable results in managing challenging bone tumor cases in the proximal femur.