Internal fixation versus endoprosthetic replacement of the proximal femur for metastatic bone disease: Single institutional outcomes.

Gusho, Charles A; Clayton, Bishir; Mehta, Nabil; Hmeidan, Wassim; Colman, Matthew W; Gitelis, Steven; Blank, Alan T · J Orthop · 2021

retrospective_cohort · Level III

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Abstract

This study compared internal fixation (IF) to proximal femur replacement (PFR) for proximal femoral metastasis. Between 2005 and 2019, 113 lesions underwent IF (<i>n</i> = 94) or PFR (<i>n</i> = 19). Revision risk was calculated with mortality as a competing event. The 5-year revision risk after IF was 17.6% (95% CI, 9.8%-27.3%) compared to 7.6% (95% CI, 0.3%-28.9%) after PFR (<i>p</i> = 0.59). PFR had longer operative times (<i>p</i> < 0.001), hospital stay (<i>p</i> = 0.039), and higher blood loss (<i>p</i> < 0.001) than IF, respectively. IF may be considered for patients with poor health and a limited prognosis given the less-invasive procedure and shorter hospital stay. III. Retrospective Study.

Anatomy