Long-term Outcome of Total Femur Replacement

Area of Science:

• Orthopedic Surgery
• Oncology
• Biomedical Engineering

Background:

• Total femur replacement is a limb salvage option for extensive bone tumors or massive bone loss after revision surgery.
• Long-term functional outcomes and survival are crucial considerations for patients undergoing this procedure.

Purpose of the Study:

• To evaluate the long-term functional outcome and survival of patients who underwent total femur replacement for primary bone tumors.
• To assess the efficacy of modular endoprosthesis in limb salvage surgery.

Main Methods:

• A retrospective review of all consecutive total femur replacements for primary bone tumors from June 1997 to May 2022.
• Patient outcomes were assessed using the Musculoskeletal Tumour Society Scoring System (MSTS) via WhatsApp surveys.
• Descriptive data analysis was performed on limb and prosthesis survival.

Main Results:

• Ten patients underwent total femur replacement, primarily for osteosarcoma.
• Seven patients were available for long-term evaluation (mean follow-up 17.6 years), with four achieving good functional outcomes (60-80%) without revision.
• Complications included acetabulum erosion, chronic pain, infection, and one case requiring hemipelvectomy.

Conclusions:

• Total femur replacement demonstrates good long-term functional outcomes and prosthesis survival.
• It is a favorable option for limb salvage surgery in the context of extensive bone tumors or significant bone loss.