Extracorporeally irradiated autograft-prosthetic composite arthroplasty using AML extensively porous-coated stem for proximal femur reconstruction: a clinical analysis of 14 patients.
OBJECTIVE
Allograft-prosthetic composite for reconstruction of the proximal femur after tumor excision is widely used as an alternative to megaprosthesis. To achieve greater biological fixation, we employed a long-stem prosthesis that is cemented proximally into the extracorporeally irradiated autograft and press-fit distally into the host femur without any supplementary plate fixation of the junction instead of the standard all-cemented technique.


METHODS
From 1997 to 2002, 14 patients underwent proximal femur reconstruction with extracorporeally irradiated autograft-prosthetic composite using an AML extensively porous-coated long stem for reconstruction of the bone defect of tumor excisions.


RESULTS
At the mean follow-up period of 65.7 months, only one patient (8.1%) developed non-union and another died of disease before union of the junction. The remaining 12 patients (85%) achieved union at a mean of 20.3 weeks (range, 14-40 weeks) without major complication. The mean functional Enneking score was 72.1% (range, 53-93%).


CONCLUSIONS
These clinical results show that this reliable and satisfactory technique promotes union through compression at the host-graft junction with weight-bearing by leaving the distal portion of the femoral stem uncemented into the host bone.
Chen
Cheng-Fong
CF
Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Department of Surgery, National Yang-Ming University, Taipei, Taiwan.
Chen
Wei-Ming
WM
Cheng
Yu-Chieh
YC
Chiang
Chao-Ching
CC
Huang
Ching-Kuei
CK
Chen
Tain-Hsiung
TH
D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002648:Child; D020099:Coated Materials, Biocompatible; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery*; D005269:Femur / Q000528:radiation effects*; D006622:Hip Prosthesis; D006801:Humans; D023821:Limb Salvage / Q000379:methods; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012509:Sarcoma / Q000601:surgery; D013945:Thymoma / Q000601:surgery; D014182:Transplantation, Autologous; D016474:Weight-Bearing
D020099:Coated Materials, Biocompatible