A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal
BackgroundPatients who undergo massive femoral malignant tumor (MFMT) resection often exhibit shortened femoral metaphyseal juxta-articular segments. The use of a customized femoral endoprosthesis (CFE) with an intra-neck curved stem (INCS) has emerged as a viable reconstructive surgical strategy fo...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.933057/full |
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| author | Qi You Qi You Minxun Lu Minxun Lu Li Min Li Min Yi Luo Yi Luo Yuqi Zhang Yuqi Zhang Yitian Wang Yitian Wang Chuanxi Zheng Chuanxi Zheng Yong Zhou Yong Zhou Chongqi Tu Chongqi Tu |
| author_facet | Qi You Qi You Minxun Lu Minxun Lu Li Min Li Min Yi Luo Yi Luo Yuqi Zhang Yuqi Zhang Yitian Wang Yitian Wang Chuanxi Zheng Chuanxi Zheng Yong Zhou Yong Zhou Chongqi Tu Chongqi Tu |
| author_sort | Qi You |
| collection | DOAJ |
| description | BackgroundPatients who undergo massive femoral malignant tumor (MFMT) resection often exhibit shortened femoral metaphyseal juxta-articular segments. The use of a customized femoral endoprosthesis (CFE) with an intra-neck curved stem (INCS) has emerged as a viable reconstructive surgical strategy for these individuals. Relative to a cemented INCS, it remains unclear as to whether cementless INCS use is associated with improvements in functionality or reconstructive longevity. As such, the present study was conducted to compare functional outcomes, endoprosthetic survival, and endoprosthesis-related complication rates in patients undergoing cemented and cementless INCS implantation.MethodsA total of 24 patients undergoing lower limb salvage and reconstructive surgical procedures utilizing cemented or cementless INCS endoprostheses were retrospectively included. Patient-functional outcomes, endoprosthetic survival, and complication rates were compared as a function of age; diagnosis; the length of femoral resection; residual proximal femur length; Musculoskeletal Tumor Society (MSTS) scores; visual analog scale (VAS) scores; and the rates of implant breakage, periprosthetic infections, periprosthetic fractures, and aseptic loosening.ResultsThe mean follow-up was 56 months. Significant differences in the length of femoral resection (p<0.001) and residual proximal femur length were observed (p<0.001) between the cemented and cementless INCS groups. There were no differences in overall patient survival and aseptic loosening-associated endoprosthesis survival in the cemented and cementless groups. None of the included patients experienced periprosthetic fractures, infections, or implant breakage. Average respective MSTS and VAS scores did not differ between groups.ConclusionFor patients undergoing treatment for MFMTs, the use of a CFE with an INCS has emerged as a viable approach to hip-preserving reconstructive surgery. With appropriately designed individualized rehabilitative programs, good functional outcomes can be achieved for these endoprostheses, which are associated with low complication rates. Moreover, the selection between cemented or cementless INCS in the clinic should be made based on patient-specific factors, with cementless INCS implementation being preferable in younger patients with good-quality bone, the potential for long-term survival, and the osteotomy site near the lesser trochanter, whereas cemented INCS use should be favored for individuals who are older, have a shorter life expectancy, or have poor bone quality. |
| first_indexed | 2024-04-11T21:15:11Z |
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| language | English |
| last_indexed | 2024-04-11T21:15:11Z |
| publishDate | 2022-09-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-c746630d1275421b8a7531fcdb35afc72022-12-22T04:02:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.933057933057A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removalQi You0Qi You1Minxun Lu2Minxun Lu3Li Min4Li Min5Yi Luo6Yi Luo7Yuqi Zhang8Yuqi Zhang9Yitian Wang10Yitian Wang11Chuanxi Zheng12Chuanxi Zheng13Yong Zhou14Yong Zhou15Chongqi Tu16Chongqi Tu17Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, ChinaSichuan Model worker and Craftsman Talent Innovation Research Studio, Chengdu, ChinaBackgroundPatients who undergo massive femoral malignant tumor (MFMT) resection often exhibit shortened femoral metaphyseal juxta-articular segments. The use of a customized femoral endoprosthesis (CFE) with an intra-neck curved stem (INCS) has emerged as a viable reconstructive surgical strategy for these individuals. Relative to a cemented INCS, it remains unclear as to whether cementless INCS use is associated with improvements in functionality or reconstructive longevity. As such, the present study was conducted to compare functional outcomes, endoprosthetic survival, and endoprosthesis-related complication rates in patients undergoing cemented and cementless INCS implantation.MethodsA total of 24 patients undergoing lower limb salvage and reconstructive surgical procedures utilizing cemented or cementless INCS endoprostheses were retrospectively included. Patient-functional outcomes, endoprosthetic survival, and complication rates were compared as a function of age; diagnosis; the length of femoral resection; residual proximal femur length; Musculoskeletal Tumor Society (MSTS) scores; visual analog scale (VAS) scores; and the rates of implant breakage, periprosthetic infections, periprosthetic fractures, and aseptic loosening.ResultsThe mean follow-up was 56 months. Significant differences in the length of femoral resection (p<0.001) and residual proximal femur length were observed (p<0.001) between the cemented and cementless INCS groups. There were no differences in overall patient survival and aseptic loosening-associated endoprosthesis survival in the cemented and cementless groups. None of the included patients experienced periprosthetic fractures, infections, or implant breakage. Average respective MSTS and VAS scores did not differ between groups.ConclusionFor patients undergoing treatment for MFMTs, the use of a CFE with an INCS has emerged as a viable approach to hip-preserving reconstructive surgery. With appropriately designed individualized rehabilitative programs, good functional outcomes can be achieved for these endoprostheses, which are associated with low complication rates. Moreover, the selection between cemented or cementless INCS in the clinic should be made based on patient-specific factors, with cementless INCS implementation being preferable in younger patients with good-quality bone, the potential for long-term survival, and the osteotomy site near the lesser trochanter, whereas cemented INCS use should be favored for individuals who are older, have a shorter life expectancy, or have poor bone quality.https://www.frontiersin.org/articles/10.3389/fonc.2022.933057/fullmassive femoral malignant tumortotal femur replacementcustomized femoral endoprosthesisintra-neck curved stemhip-preserving reconstruction |
| spellingShingle | Qi You Qi You Minxun Lu Minxun Lu Li Min Li Min Yi Luo Yi Luo Yuqi Zhang Yuqi Zhang Yitian Wang Yitian Wang Chuanxi Zheng Chuanxi Zheng Yong Zhou Yong Zhou Chongqi Tu Chongqi Tu A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal Frontiers in Oncology massive femoral malignant tumor total femur replacement customized femoral endoprosthesis intra-neck curved stem hip-preserving reconstruction |
| title | A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal |
| title_full | A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal |
| title_fullStr | A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal |
| title_full_unstemmed | A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal |
| title_short | A comparison of cemented and cementless intra-neck curved stem use during hip-preserving reconstruction following massive femoral malignant tumor removal |
| title_sort | comparison of cemented and cementless intra neck curved stem use during hip preserving reconstruction following massive femoral malignant tumor removal |
| topic | massive femoral malignant tumor total femur replacement customized femoral endoprosthesis intra-neck curved stem hip-preserving reconstruction |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.933057/full |
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