Acta Biomedica Scientia

FUNCTIONAL OUTCOMES OF MODULAR TUMOR PROSTHESES IN METASTATIC PROXIMAL FEMORAL TUMORS: A RETROSPECTIVE STUDY

Dr. Suryavara Prasad B

Metastatic bone disease, proximal femur, modular prosthesis, pathological fracture

Metastatic bone disease commonly affects the proximal femur, frequently originating from primary cancers such as breast, lung, kidney, prostate, and thyroid. These lesions carry a high risk of pathological fractures and implantrelated complications, necessitating effective management strategies. Objective: This study evaluated the clinical outcomes of modular prosthetic reconstruction of the proximal femur following tumor resection in patients with metastatic bone disease. Methods: A total of 175 patients, including 150 with pathological fractures or fixation complications and 25 at high risk of fractures, underwent proximal femoral reconstruction using modular prostheses developed in collaboration with a biomedical engineering department. Treatment decisions were multidisciplinary, based on femoral damage extent and metastatic prognosis. Functional and radiological assessments were performed postoperatively. Results: Limb amputation was required in only 5% of cases. The rates of postoperative infection and dislocation were comparable to or better than previously reported data, with large monopolar heads reducing dislocation risk. Although aseptic loosening was observed, especially in advanced renal carcinoma cases, hydroxyapatite-coated collars contributed to mitigating this complication. Compared to internal fixation, endoprosthetic reconstruction demonstrated advantages in cost-effectiveness, reduced need for revision surgeries, and implant longevity. Survival following surgery was notably longer in patients with metastatic renal carcinoma compared to those with hepatocellular carcinoma or adenocarcinoma. Despite high overall mortality, surgical intervention improved patients’ daily functioning and quality of life more effectively than conservative therapies. Conclusion: Modular prosthetic replacement of the proximal femur is a safe, reliable, and beneficial surgical option for patients with metastatic lesions, providing functional improvement and enhancing quality of life while maintaining manageable complication rates