Journal article
When is hemiarthroplasty preferable to intramedullary prophylactic fixation of malignant lesions of the proximal femur?
Journal of surgical oncology, Vol.116(8), pp.1132-1140
12/15/2017
DOI: 10.1002/jso.24792
PMID: 28793180
Abstract
BackgroundMalignant hip lesions can be managed operatively by intramedullary (IM) nail fixation and hemiarthroplasty.
MethodsA retrospective review was performed on 86 patients who underwent hemiarthroplasty (n=22) or IM nail fixation (n=64) for prophylactic treatment of impending pathologic fracture due to malignant lesions of the hip. Cox proportional hazards and logistic regression modeling were performed to determine risk of death, fixation failure, pain relief, and return to ambulation without gait aids.
ResultsMedian survival time after surgery was 8.8 months (with no difference in survival between hemiarthroplasty and IM nail [adjusted Hazard Ratio 1.40, CI 0.72, 2.53; P=0.31]). Hemiarthroplasty was associated with lower risk of pathologic fracture, fixation failure, or reoperation (adjusted HR 0.02, CI<0.001, 0.48; P=0.01). Hemiarthroplasty did not increase odds of unassisted ambulation compared to IM nail fixation (adjusted Odds Ratio [OR] 2.23, CI 0.56, 9.71; P=0.26). The strongest predictor of postoperative ambulation was preoperative ambulation without aids (adjusted OR 28.9, CI 7.37, 161; P<0.001).
ConclusionsThere is no difference in survival or likelihood of unassisted ambulation after prophylactic femoral fixation with IM nails versus hemiarthroplasty in patients with metastatic disease of proximal femur.
Details
- Title: Subtitle
- When is hemiarthroplasty preferable to intramedullary prophylactic fixation of malignant lesions of the proximal femur?
- Creators
- James S. Lin - The Ohio State UniversityJuan E. Santiago-Torres - The Ohio State University Wexner Medical CenterJoshua S. Everhart - The Ohio State University Wexner Medical CenterNicole E. Zayan - The Ohio State UniversityJoel L. Mayerson - The Ohio State University Wexner Medical CenterThomas J. Scharschmidt - The Ohio State University
- Resource Type
- Journal article
- Publication Details
- Journal of surgical oncology, Vol.116(8), pp.1132-1140
- DOI
- 10.1002/jso.24792
- PMID
- 28793180
- NLM abbreviation
- J Surg Oncol
- ISSN
- 0022-4790
- eISSN
- 1096-9098
- Publisher
- Wiley
- Number of pages
- 9
- Language
- English
- Date published
- 12/15/2017
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9985237601002771
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