Hip Arthroplasty With Long-stem Biological Prothesis Combined With Autogenous Deactivated Segmental Tumor Bone Grafts For The Treatment Of Proximal Femoral Tumor: 22 Cases Analysis

Object: To investigate the feasibility of using hip arthroplasty with long-stem biological prosthesis combined with autogenous deactivated segmental tumor bone grafts to treat proximal femoral tumor.Method: Twenty-two patients(22 hips)undergoing hip arthroplasty with long-stem biological prosthesis combined with autogenous deactivated segmental tumor bone grafts were retrospectively evaluated in The Second Affiliated Hospital of Chongqing medical university.14 male and 8 female,six were osteoclastoma,five osteochondrosarcoma,four osteosarcoma,three squamous carcinoma and three adenocarcinoma.According the Enneking staging,15 patients were stage II,7 patients were stage III.All the statistic data of X-ray,CT,MR and ECT were collected.The tissue of tumor,the proximal and distal bone organization of cutting edge.Femoral osteotomy were performed under the tumor of bone 5cm at least and range of 3cm soft tissue according the preoperative plan.Soft tissue including tumor were eliminated completely from the autogenous bone.Then the autogenous deactivated bone were used to reconstruct hip joint and muscle with hip arthroplasty after deactivated by boiling 15 minutes.All the patients excised by continuous passive motion early postoperation.Result: The mean follow-up were 8.3 months(range,5-12),all patients were alive without hip tumor recurrence,except two patient died of his worsen cancer after five months of surgery.None complications of hip joint dislocation,prosthesis loosing and periprosthetic fracture were observed.Clinical and radiographic examination showed that bone union between deactivated bone and femoral shaft was observed in 15 cases for 9.3 months in average,7 cases didn't achieve bony union until the end of follow-up.According to the ISLOS score of postoperative function reconstruction of bone tumor,10 patients were 28 points,5 patients were 26 points,4 patients were 25 points,2 patients were 24 points,average score was 25.7 points(range,23-28 points).Conclusion: hip arthroplasty with long-stem biological prosthesis combined with autogenous deactivated segmental tumor bone grafts for the treatment of proximal femoral tumor can achieve better hip function and don't increase the tumor recurrence rate.Controlling operative indication strictly with this surgery would be a safe and useful stratagem.