Long-term Outcome of Total Femur Replacement
https://doi.org/10.5704/MOJ.2307.004
- Author:
Adzhar AL
1
;
Faisham WI
1
;
Zulmi W
2
;
Azman WS
3
;
Sahran Y
1
;
Syurahbil AH
1
;
Nor-Azman MZ
1
Author Information
1. Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia
2. Department of Orthopaedics, Prince Court Medical Centre, Kuala Lumpur, Malaysia
3. Department of Plastic Surgery, Universiti Sains Malaysia, Kubang Kerian, Malaysia
- Publication Type:Journal Article
- Keywords:
total femur replacement, long-term outcome, limb salvage surgery
- From:Malaysian Orthopaedic Journal
2023;17(No.2):21-27
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Total femur replacement is an option instead
of amputation for extensive bone tumour or after revision
surgery with a massive bone loss. Over a long period of time
the patients may need revision surgery, and this might affect
the functional outcome. We reviewed all consecutive total
femur replacements done for primary and revision surgery of
primary bone tumours in our centre to evaluate the long-term
functional outcome and survival.
Materials and methods: All patients who had total femur
resection and reconstruction with modular endoprosthesis
replacement in our centre from June 1997 to May 2022 were
reviewed. The respondents were surveyed through
WhatsApp using google form which was translated into
Bahasa Malaysia based on the Musculoskeletal Tumour
Society Scoring System (MSTS). The data were presented as
descriptive data on the final survival of the limb and
prosthesis.
Results: Ten patients underwent total femur replacement.
There were eight osteosarcoma, one giant cell tumour and
one chondromyxoid fibroma. Three patients with
osteosarcoma succumbed to pulmonary metastases; all had
good early post-operative functional outcomes without local
recurrence. Seven patients were available for long term
evaluation of function with a mean follow-up of 17.6 years
(ranged 10-25 years). Four patients with total femur
replacement had good functional outcomes (60-80%)
without revision with 10-25 years follow-up. Three patients
experienced acetabulum erosion and chronic pain that
required early hip replacements. Two of them were
complicated with superior erosions and bone loss and
subsequently were managed with massive reconstruction
using cemented acetabulum cage reconstruction. The other
has diabetes mellitus with chronic infection following
revision of distal femur endoprosthesis to total femur
replacement and subsequently underwent limited
hemipelvectomy after 14 years.
Conclusion: Total femur replacement offers a good long
term functional outcome and prosthesis survival and is a
favourable option for limb salvage surgery.
- Full text:16.2023my1315.pdf
