Proximal femoral allograft: prognostic indicators

J Arthroplasty. 2010 Oct;25(7):1028-33. doi: 10.1016/j.arth.2009.07.018. Epub 2009 Oct 30.

Abstract

Between 1972 and 1999, the Orthopedic Oncology Service treated 150 patients with resection and allograft transplantation of the proximal femur. Of the group, 121 patients had malignant tumors of the proximal femur and 29 had benign disorders. Four types of allografts were used: osteoarticular (46 patients), allograft-prosthesis (73), intercalary (20), and allograft-arthrodesis (5). Only 16% of the patients died of disease and 3% required amputation. The overall success rate for the series was 77% with the best results for the allograft prosthetic (82%) and intercalary procedures (87%). Graft infection (15 patients), allograft fracture (26 patients), and local recurrence (11 patients) most markedly affected outcome. With the exception of deaths of disease, no significant outcome difference occurred between the patients with malignant and benign disorders. In conclusion, allograft implantation especially for aggressive or malignant tumors of the proximal femur appears to be a competent system for therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Diseases / mortality
  • Bone Diseases / surgery*
  • Bone Neoplasms / mortality
  • Bone Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Female
  • Femur / surgery*
  • Femur / transplantation*
  • Fibrous Dysplasia of Bone / mortality
  • Fibrous Dysplasia of Bone / surgery
  • Gaucher Disease / mortality
  • Gaucher Disease / surgery
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Osteochondroma / mortality
  • Osteochondroma / surgery
  • Osteonecrosis / mortality
  • Osteonecrosis / surgery
  • Prognosis
  • Radiography
  • Retrospective Studies
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult