Uncemented total hip arthroplasty in patients with systemic malignancy without skeletal involvement: A retrospective...

With improved cancer survival rates, patients in remission from systemic malignancies without skeletal metastases represent a growing subset of patients seeking total hip arthroplasty (THA). However, these cases often fall outside conventional orthopaedic oncology pathways, and data on their outcomes remain limited.

We retrospectively reviewed 33 uncemented THAs performed in 28 pre-operatively medically optimised onco-geriatric patients, without significant bone loss (aged 66-89) between 2020 and 2024 at a district general hospital in England. All patients had a history of solid tumours or haematologic malignancies, were in remission of their disease without any bone involvement at the time of surgery and underwent uncemented THA using Corail collared femoral stems with Pinnacle acetabular cups. Outcomes assessed included implant stability (radiographic and clinical osseointegration), perioperative and postoperative complications, and functional recovery measured by the Oxford Hip Score, with a median follow-up of one year.

Early outcomes were excellent, despite concerns about bone quality in this cohort. There were no revisions or periprosthetic fractures, and no cases of prosthetic dislocation, deep infection, or radiographic loosening at one-year follow-up. All implants achieved stable fixation, and functional scores were high-comparable to those reported for THA patients without cancer.

These findings suggest that a cancer diagnosis alone should not preclude the use of uncemented fixation in THA. In well-selected older patients with prior malignancy but no local skeletal disease, uncemented THA proved to be a viable, safe reconstructive option. This case series addresses an understudied patient population and supports expanding the indications for uncemented THA in onco-geriatric patients without skeletal metastases.