TY - JOUR
T1 - Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure A prospective population-based study
AU - Sørensen, Michala Skovlund
AU - Horstmann, Peter Frederik
AU - Hindsø, Klaus
AU - Petersen, Michael Mørk
PY - 2019
Y1 - 2019
N2 - Background and objectives: Endoprosthesis is considered a durable implant for treating metastatic bone disease of the proximal femur (MBDf). Objectives: • What is the revision risk after surgery for MBDf using endoprosthesis versus internal fixation? • When do patients with MBDf treated with endoprosthesis restore quality of life (QoL) and how long time does it take to rehabilitate functional outcome? Methods: A prospective, population-based, multicentre study of 110 patients. Patients were followed for a minimum of two years after surgery. No patients were lost to implant failure nor survival follow-up. Results: Forty-four patients were treated with internal fixation and 66 patients received endoprostheses. Two-year implant failure risk for internal fixation was 7% (95CI: 0–14%) versus 2% (95CI: 0–5%) for endoprostheses (p = 0.058). Eq-5D improved to the same level as one month prior to surgery six-weeks after surgery, and the score improved further six months after surgery (median score from 0.603 to 0.694, p = 0.007). MSTS score increased from 12 points after surgery to 23 points six-months after surgery (p<0.001). Conclusions: Endoprosthesis for treatment of MBDf results in low implant failure rate. Patients are satisfied with the functional outcome. QoL is restored six-weeks after surgery. Authors advocate for caution using internal fixation for MBDf due to findings of a possible high early postoperative revision risk.
AB - Background and objectives: Endoprosthesis is considered a durable implant for treating metastatic bone disease of the proximal femur (MBDf). Objectives: • What is the revision risk after surgery for MBDf using endoprosthesis versus internal fixation? • When do patients with MBDf treated with endoprosthesis restore quality of life (QoL) and how long time does it take to rehabilitate functional outcome? Methods: A prospective, population-based, multicentre study of 110 patients. Patients were followed for a minimum of two years after surgery. No patients were lost to implant failure nor survival follow-up. Results: Forty-four patients were treated with internal fixation and 66 patients received endoprostheses. Two-year implant failure risk for internal fixation was 7% (95CI: 0–14%) versus 2% (95CI: 0–5%) for endoprostheses (p = 0.058). Eq-5D improved to the same level as one month prior to surgery six-weeks after surgery, and the score improved further six months after surgery (median score from 0.603 to 0.694, p = 0.007). MSTS score increased from 12 points after surgery to 23 points six-months after surgery (p<0.001). Conclusions: Endoprosthesis for treatment of MBDf results in low implant failure rate. Patients are satisfied with the functional outcome. QoL is restored six-weeks after surgery. Authors advocate for caution using internal fixation for MBDf due to findings of a possible high early postoperative revision risk.
KW - Functional outcome
KW - Mega-prothesis
KW - Metastatic bone disease of the proximal femur
KW - Pathological fracture
KW - Quality of life
KW - Surgery
KW - Tumour prosthesis
U2 - 10.1016/j.jbo.2019.100264
DO - 10.1016/j.jbo.2019.100264
M3 - Journal article
C2 - 31871883
AN - SCOPUS:85074538062
VL - 19
JO - Journal of Bone Oncology
JF - Journal of Bone Oncology
SN - 2212-1366
M1 - 100264
ER -