Cemented Endoprosthetic Replacement for Metastatic Bone Disease in the Proximal Femur

Abstract In long bones, the most common site for metastases is the proximal femur. For lesions involving this region, osteosynthetic devices frequently fail, and for this reason, endoprosthetic reconstruction may be the optimal choice for treatment. Here, we present a series of 44 patients in whom 45 endoprosthetic reconstructions were performed for metastatic disease. In 28 patients (63.63%), endoprosthetic reconstruction was performed for pathologic fractures, and in 16 patients (36.37%), it was performed for impending fractures indicated by complaints of pain and problems with walking. Full weight bearing was achieved in the early postoperative period in 72.09% of our patients, and sufficient pain control was obtained in all patients. Four patients did not survive past the first 72 hours after surgery, and 11 more patients died within 2 months after surgery. A total of 29 patients (65.9%) survived to the 2-month follow-up visit, and of these, only 12 patients (27.2%) survived past the first postoperative year. We believe that in patients with metastatic disease in the proximal femur, endoprosthetic reconstruction can provide early and stable fixation with pain reduction and good functional results.