title: Custom-made endoprostheses for the femoral amputation stump: an alternative to hip disarticulation in tumour surgery.
abstract: Disarticulation of the hip in patients with high-grade tumours in the upper thigh results in significant morbidity. In patients with no disease of the proximal soft tissue a femoral stump may be preserved, leaving a fulcrum for movement and weight-bearing. We reviewed nine patients in whom the oncological decision would normally be to disarticulate, but who were treated by implantation of an endoprosthesis in order to create a functioning femoral stump. The surgery was undertaken for chondrosarcoma in four patients, pleomorphic sarcoma in three, osteosarcoma in one and fibrous dysplasia in one. At follow-up at a mean of 80 months (34 to 132), seven patients were alive and free from disease, one had died from lung metastases and another from a myocardial infarction. The mean functional outcome assessment was 50 (musculoskeletal tumor society), 50 and 60 (physical and mental Short-form 36 scores). Implantation of an endoprosthesis into the stump in carefully selected patients allows fitting of an above-knee prosthesis and improves wellbeing and the functional outcome.
authors.affiliation: Medical School, The Stopford Building, Manchester University, Oxford Road, Manchester, M13 9PT, UK. nickkalson@gmail.com
authors.forename: N S
authors.initials: NS
authors.lastname: Kalson
authors.forename: P D
authors.initials: PD
authors.lastname: Gikas
authors.forename: W
authors.initials: W
authors.lastname: Aston
authors.forename: J
authors.initials: J
authors.lastname: Miles
authors.forename: G
authors.initials: G
authors.lastname: Blunn
authors.forename: R
authors.initials: R
authors.lastname: Pollock
authors.forename: J
authors.initials: J
authors.lastname: Skinner
authors.forename: T W R
authors.initials: TW
authors.lastname: Briggs
authors.forename: S R
authors.initials: SR
authors.lastname: Cannon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods; D000672:Amputation Stumps; D003131:Combined Modality Therapy; D004188:Disarticulation; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery* / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D016459:Prosthesis-Related Infections / Q000209:etiology; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult