Endoprosthetic replacement for primary malignant tumors of the proximal femur

Fifty-four patients had endoprosthetic replacement of the proximal femur after resection of primary malignant or aggressive bone tumors. The mean age of the patients was 41 years. The average duration of followup was 9 years (range, 5-24 years). At the time of this review 35 patients are surviving. There were six revisions of the acetabulum and seven revisions of the femoral component. The survivorship of the prostheses without revision was 77% at 10 years falling to 57% at 20 years. There was a 13% risk of amputation and a 1.8% incidence of infection. The mean of the functional scores of the 35 living patients was 83% (range, 60%-97%). This study showed that successful long term results can be obtained with cemented massive endoprostheses despite the incidence of recognized complications including polyethylene wear and aseptic loosening.