Use of endoprostheses for proximal femur metastases results in a rapid rehabilitation and low risk of implant failure. A prospective population-based study

• Published in: Journal of bone oncology 2019-12, Vol.19, p.100264, Article 100264
• Main Authors: Sørensen, Michala Skovlund, Horstmann, Peter Frederik, Hindsø, Klaus, Petersen, Michael Mørk
• Format: Article
• Language: English
• Subjects: Functional outcome; Mega-prothesis; Metastatic bone disease of the proximal femur; Pathological fracture; Quality of life; Surgery; Tumour prosthesis
• ISSN: 2212-1374; 2212-1366; 2212-1374
• DOI: 10.1016/j.jbo.2019.100264

•Endoprosthesis compared to internal fixation in treating metastatic lesions of the proximal femur does not results in prolonged in-hospital time.•The use of endoprosthesis seems to pose a lower risk of implant failure compared to internal fixation already 3 months after surgery.•Patients treated with an endoprosthesis restore quality of life six weeks after surgery.•Patients treated with an endoprosthesis improve functional outcome during the first 6 months. Endoprosthesis is considered a durable implant for treating metastatic bone disease of the proximal femur (MBDf). • 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? 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. 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