[Reconstruction prosthesis of the upper part of the femur. Intermediate results in 20 resections for tumor. Current trends].
Twenty total hip prostheses inserted after massive resection of the upper part of the femur for tumour have been reviewed after a 3 year mean follow-up. Fifteen cases were of primary malignant tumour. The mean resection of the femur measured 175 mm in length and was reconstructed using Cochin prostheses. From the oncological standpoint, the results were comparable with those obtained after disarticulation of the hip, but the functional results were, of course, much better. Five patients were able to resume their previous professional work; 13 were able to have a normal type of life and only 2 were severely crippled. Nineteen hips were painless. Nine patients could walk without a stick, 9 used one stick for walking outside and 2 used sticks permanently. Two cases were complicated by dislocation. Despite an extensive resection of the greater trochanter, one third of the hips were stable on standing on one leg, thanks to the design of the prostheses. No prostheses broke. Two loosenings of the acetabular cup had to be revised. No loosening of the femoral stem was found, despite the frequency of osteolysis of the diaphysis to 4-5 cms below the level of resection. The authors intend now to improve the design of the prostheses and to aid the reinsertion of the muscles, which can be improved by using homografts surrounding the femoral prostheses.
D005266:Femoral Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000502:physiology; D006622:Hip Prosthesis; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D009068:Movement; D010014:Osteolysis / Q000209:etiology; D010146:Pain; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography
Prothèse de reconstruction de l'extrémité supérieure du fémur. Résultats à moyen terme de 20 résections pour tumeurs. Orientations actuelles.