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Hamidzadeh Khiavi A, Shams R, Hajialiloo Sami S. Outcomes of Shelf Procedure in Acetabulum Reconstruction for Preventing Hip Dislocation Following Proximal Femur Tumor Resection. JROS 2024; 11 (1)
URL: http://jros.iums.ac.ir/article-1-2277-en.html
URL: http://jros.iums.ac.ir/article-1-2277-en.html
1- Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract: (39 Views)
Objective: Hip instability following proximal femoral arthroplasty (PFA) after tumor resection remains a significant challenge. This study aimed to evaluate the clinical outcomes of acetabulum reconstruction using a shelf procedure in patients undergoing bipolar femur replacement after proximal femur tumor resection, focusing on dislocation rates and other complications.
Methods: This retrospective cohort study was conducted on 32 patients (21 males, 11 females) who underwent bipolar femur replacement with cemented shelf procedures following tumor resection. Data were collected from tumor databases, operating records, and pathology reports. The primary outcome was dislocation rate, with secondary outcomes, including fractures, infections, and implant survival. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system.
Results: The average follow-up period was 77.46 months (range: 7–216 months). Primary tumors accounted for 68.75% of cases, with a 45% recurrence rate, while metastatic cases had a 70% recurrence rate. Orthopedic complications were observed in 78.1% of patients, with fractures, dislocations, and infections each occurring in a small percentage of cases. The dislocation rate was 6.3%, significantly lower than rates reported in previous studies. Lung metastasis was the leading cause of death in 71.43% of deceased patients.
Conclusion: Bipolar hemiarthroplasty combined with acetabulum reconstruction using the shelf procedure provides favorable functional outcomes and effective hip articulation, with a lower dislocation rate compared to other methods. This approach is a viable option for patients undergoing proximal or total femoral resection due to musculoskeletal tumors.
Methods: This retrospective cohort study was conducted on 32 patients (21 males, 11 females) who underwent bipolar femur replacement with cemented shelf procedures following tumor resection. Data were collected from tumor databases, operating records, and pathology reports. The primary outcome was dislocation rate, with secondary outcomes, including fractures, infections, and implant survival. Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system.
Results: The average follow-up period was 77.46 months (range: 7–216 months). Primary tumors accounted for 68.75% of cases, with a 45% recurrence rate, while metastatic cases had a 70% recurrence rate. Orthopedic complications were observed in 78.1% of patients, with fractures, dislocations, and infections each occurring in a small percentage of cases. The dislocation rate was 6.3%, significantly lower than rates reported in previous studies. Lung metastasis was the leading cause of death in 71.43% of deceased patients.
Conclusion: Bipolar hemiarthroplasty combined with acetabulum reconstruction using the shelf procedure provides favorable functional outcomes and effective hip articulation, with a lower dislocation rate compared to other methods. This approach is a viable option for patients undergoing proximal or total femoral resection due to musculoskeletal tumors.
Keywords: Proximal femoral arthroplasty, Acetabulum reconstruction, Hip dislocation, Bipolar hemiarthroplasty, Tumor resection
Type of Study: Research Article |
Subject:
Tumor surgery
Received: 2025/02/18 | Accepted: 2025/03/24 | Published: 2024/02/13
Received: 2025/02/18 | Accepted: 2025/03/24 | Published: 2024/02/13
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