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Year : 2018  |  Volume : 53  |  Issue : 1  |  Page : 70-76

Modular megaprosthesis for proximal femoral tumors

Department of Orthopaedics, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

Correspondence Address:
Adel R Ahmed
Elhadara University Hospital, Elhadara, Lambrouzou, Alexandria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eoj.eoj_19_18

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Objectives Limb salvage surgery is the preferred treatment for proximal femoral tumors. The use of modular prosthesis following resection of the tumor is the preferred method, a procedure that is technically demanding. The resection of tumor at the level of proximal femur results in loss of abductors and other musculature necessary for hip stability. This often leads to a higher instability rate. Hip dislocation is a recognized problem after the use of megaprosthesis, with rates of dislocation varying from 1.7% to ∼28%. Patients and methods Between March 2003 and March 2008, 15 patients in our series had resection of the proximal femoral primary malignant tumors and implantation of a modular megaprostheses, using a bipolar acetabular cup. There were seven women and eight men, with a mean age of 37 years (18–68 years). The diagnoses were osteosarcoma (two), chondrosarcoma (eight), malignant fibrous histiocytoma (two), and giant cell tumor (three). All patients had a complete tumor workup before surgery that included routine blood work, bone scan, computed tomography of the chest, and MRI of the femur. All patients had an open biopsy. They were given preoperative radiotherapy and chemotherapy as required. Results The mean follow-up was 5 years (range, 5 months–10 years). Two patients died of causes not related to the prosthesis. The postoperative Musculoskeletal Tumor Society score was 26 (range, 23–30) for the remaining 13 patients. There were one subluxation treated conservatively, and one erosion of the acetabulum that needed conversion into total hip replacement. No infections and local recurrence were encountered. Conclusion Proximal femoral modular megaprosthesis is a good option for reconstruction after resection of proximal femoral tumors.

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