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Friday, March 2, 2001

Technique restores hip joint stability

Dislocation is the most common complication following proximal and total femur endoprosthetic reconstruction. The study in poster exhibit 176 describes the surgical technique of acetabular preservation and reconstruction of the joint capsule and abductor mechanism that recreates joint stability and avoids dislocation after proximal and total femur resections.

Between 1980 and 1996, 57 patients underwent proximal or total femur resection with endoprosthetic reconstruction. Forty-six patients had a primary bone sarcoma, nine had other malignant bone tumors, and two had metabolic bone disease. Principles of resection and reconstruction included:

Follow-up averaged 6.5 years (range: 2-18.2 years) and included physical and radiological evaluation and functional evaluation according to the American Musculoskeletal Tumor Society System.

Dislocation occurred in only one patient (1.7 percent). This patient was skeletally immature at the time of surgery. The dislocation occurred almost five years after surgery and was secondary to acetabular dysplasia. Aseptic prosthetic loosening occurred in three (5.3 percent) patients. Function was estimated to be good or excellent in 46 patients (81%) and fair in 11 patients (19 percent). No difference in function was found between patients who underwent proximal femur replacement and those who underwent total femur replacement.

Acetabular preservation, hip joint capsulorraphy, and reconstruction of the abductor mechanism recreate hip joint stability and avoid dislocation following proximal and total femur endoprosthetic reconstruction, the investigators concluded.

The investigators are Jacob Bickels, MD, Sourasky Medical Center, Tel-Aviv, Israel; James C. Wittig, MD, Washington Hospital Center, Washington, D.C.; Yehuda Kollender, MD, Tel-Aviv Medical Center, Tel-Aviv, Israel; Robert M. Henshaw, MD, Washington Cancer Institute, Washington, D.C.; Isaac Meller, MD, Sourasky Medical Center, Tel-Aviv, Israel; and Martin M. Malawer, MD, Washington Cancer Center, Washington, D.C.

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2001 Academy News March 2 Index B

Last modified 20/February/2001 by IS