Total hip arthroplasty for treatment of bone metastases

Background. Bone metastases are observed in many patients with neoplastic disease. Frequently, the first sign of metastasis is a pathological fracture in weight bearing regions. The proximal end of the femur is the most common site of long bone involvement by metastatic disease and pathological fracture. Treatment of metastatic disease should be multidisciplinary: both oncologic and orthopedic. The target of operative procedure is a relief of pain and regaining the ability to walk. In case of changes in proximal end of the femur, the tumor resection and total hip arthroplasty is a procedure of choice.
Material and methods. In the Orthopedic Clinic in Warsaw, 27 patients with bone metastases in proximal end of the femur had total hip arthroplasty performed in the period of 1998-2002. In 16 cases it was possible to collect data about postoperative period - these patients were analyzed. In 14 patients postresective prostheses were used and in 2 procedures - standard prostheses.
Results and Conclusions. This type of treatment reduced pain, restored weight bearing ability of the limb and improved comfort of life. Subjective estimation of treated patients was good. Only in one case the clinical result was poor. Total hip arthroplasty is an efficacious palliative treatment in patients with metastases in proximal end of the femur. Final effect of therapy depends on individual precise preoperative planning and multidisciplinary specialist postoperative care.