Effectiveness of total femoral replacement in limb-salvage procedure in adolescent patients with femoral malignant tumors
CUI Lu-kuan
SUN Yang
JIN Tao
LIU Wei-feng
Abstract：Objective To evaluate the effectiveness of total femoral prosthesis replacement in limb-salvage in adolescent patients with femoral malignant tumors.Methods Adolescent patients with femoral malignant tumors who had undergone total femoral prosthesis replacement from January 2000 to October 2023 in Beijing Jishuitan Hospital were reviewed.Their general information,tumor type,survival rate and postoperative complications were recorded.The function of surviving patients was scored by MSTS score,and the survival rate was calculated by Kaplan-Meier curve.Results A total of 50 adolescent patients with malignant tumor of femur received total femur replacement,with an average age of(13.22±3.32)years(range:5-18 years).In total,28 males and 22 females were included,including 46 cases of osteosarcoma,3 cases of Ewing's sarcoma and 1 case of malignant lymphoma.Tumor stage:stageⅠB in 1 case,ⅡB in 29 cases and Ⅲ in 20 cases.There were 43 cases of initial total femur replacement and 7 cases of revision with total femur prosthesis.Tumor location:27 cases were on the left side and 23 on the right side;femoral shaft in 8 cases,middle and upper femur in 2 cases,middle and lower femur in 17 cases,distal femur with skip lesion in the proximal part in 11 cases,and whole femoral shaft in 12 cases.Among 36 patients,54 complications occurred,of which 24 were related to tumor progression,accounting for 44.44%of the total complications.The length discrepancy of lower limbs accounted for 31.48%(17 cases).19 patients died after an average of(19.53±14.09)months(range:3-53 months).Thirty-one patients survived,with an overall survival rate of 62%.The MSTS score at final follow-up was(25.07±2.86)(range:20-30).Conclusions Total femur replacement is an effective method for the treatment of adolescent patients with malignant tumors that extensively involving the femur.The functional outcomes of surviving patients are good.However,the complication and mortality rates are still high.The main complications are tumor progression and length discrepancy of lower limbs.
Keywords：FemurNeoplasmsLimb-salvageAdolescentTotal femoral replacement
Publication Date：2025-02-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 100-106 )