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Prosthetic hip replacement for pathologic or impending pathologic fractures in myeloma
P J Papagelopoulos1, E C Galanis, P R Greipp
1Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA.
Clinical Orthopaedics and Related Research
|August 1, 1997
Summary
Hip replacement surgery for plasmacytoma or multiple myeloma offers significant pain relief and functional recovery. Patients with plasmacytoma showed longer survival rates compared to those with multiple myeloma.
Area of Science:
- Orthopedic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Multiple myeloma and plasmacytoma can extensively affect the hip region, necessitating complex treatment strategies.
- Hip involvement in these plasma cell disorders presents unique challenges for surgical management and patient outcomes.
Purpose of the Study:
- To evaluate the outcomes of hip replacement surgery in patients with hip plasmacytoma or multiple myeloma.
- To assess complications, functional recovery, pain relief, and survival rates following prosthetic hip reconstruction.
Main Methods:
- Retrospective review of 53 hip replacements in 50 patients (mean age 65) with hip plasmacytoma or multiple myeloma.
- Analysis of perioperative chemotherapy, radiation therapy, complication rates, functional status, pain relief, and survival data.
Main Results:
- 15 complications (28%) occurred within a mean follow-up of 32.6 months.
- 98% achieved hip pain relief, and all regained previous ambulatory status postoperatively.
- Median survival was 18 months for multiple myeloma and 6.3 years for plasmacytoma; 84% of patients died during follow-up.
Conclusions:
- Prosthetic hip replacement is indicated for extensive hip lesions in patients with plasmacytoma or multiple myeloma due to favorable functional outcomes and survival.
- Patients with plasmacytoma experience significantly longer survival than those with multiple myeloma following hip reconstruction.