Long-term functional and radiological outcomes of allograft hip prosthesis composite. A fourteen -year follow-up study
- 811 Downloads
Allograft hip composite prosthesis (APC) is a type of reconstruction after resection of the proximal femur. This study aimed to assess long-term outcomes after an APC reconstruction.
Materials and methods
Forty-six patients were retrospectively included (14 revision total hip replacements, 30 primary malignant bone tumors, two metastasis).
The mean length of femoral bone resection was 16.4 cm (7 to 27). With a mean follow-up of 14.7 years (6.3 to 32.6), Postel-Merle d’Aubigné score was 15.7 (8 to 21), Musculoskeletal Tumor Society score at 23.1 or 77% (15 to 29), and abductor strength at 3.4 (2 to 5). Allograft resorption was minor for 20 patients (44.4%), moderate for 13 patients (28.9%), and severe for 12 patients (26.7%). Host-allograft shaft bone fusion was achieved in 37 cases (84.1%). Trochanteric fracture occurred in 26 cases (59.1%). Length of femoral resection, allograft bone resorption, and trochanteric fracture did not have an effect on functional outcomes. At ten years follow-up, overall revision-free and femoral stem survivals were 54.1 ± 0.8% and 81.4 ± 0.6% respectively. No parameter evaluated influenced the survivorship.
APC is a reliable reconstruction adapted for huge proximal femoral bone resections. Trochanteric fracture and allograft bone resorption do not seem to influence functional results.
Level of evidence: Level IV
KeywordsAbductor strength Allograft hip prosthesis Allograft resorption Primary malignant bone tumor Trochanteric fracture
Allograft hip Prosthesis Composite
MusculoSkeletal Tumor Society
Revision Hip Arthroplasty
Magnetic Resonance Imaging
The authors are grateful to the SOFCOT (The French Society of Orthopaedic and Trauma Surgery) and its participating members for the financing and the support of this multicentre retrospective study.
Compliance with ethical standards
Conflict of interest
No author received any financial support that might pose a conflict of interest in connection with the submitted article. No author or any member of his or her immediate family, has no funding or commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
I agree and confirm this statement as true.
There is no funding source.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Horowitz SM, Glasser DB, Lane JM, Healey JH (1993) Prosthetic and extremity survivorship after limb salvage for sarcoma. How long do the reconstructions last? Clin Orthop 293:280–286Google Scholar
- 6.Anract P, Coste J, Vastel L, Jeanrot C, Mascard E, Tomeno B (2000) Proximal femoral reconstruction with megaprosthesis versus allograft prosthesis composite. A comparative study of functional results, complications and longevity in 41 cases. Rev Chir Orthopédique Réparatrice Appar Mot 86(3):278–288Google Scholar
- 10.Min L, Tang F, Duan H, Zhou Y, Zhang W-L, Shi R et al (2015) Cemented allograft-prosthesis composite reconstruction for the proximal femur tumor. OncoTargets Ther 8:2261–2269Google Scholar
- 11.D’Antonio J, McCarthy JC, Bargar WL, Borden LS, Cappelo WN, Collis DK et al (1993) Classification of femoral abnormalities in total hip arthroplasty. Clin Orthop 296:133–139Google Scholar
- 13.Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 286:241–246Google Scholar
- 14.Gitelis S, Heligman D, Quill G, Piasecki P (1988) The use of large allografts for tumor reconstruction and salvage of the failed total hip arthroplasty. Clin Orthop 231:62–70Google Scholar
- 15.Benedetti MG, Bonatti E, Malfitano C, Donati D (2013) Comparison of allograft-prosthetic composite reconstruction and modular prosthetic replacement in proximal femur bone tumors: functional assessment by gait analysis in 20 patients. Acta Orthop 84(2):218–223CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Meding JB, Ritter MA, Davis KE, Hillery M (2015) Cemented and uncemented total hip arthroplasty using the same femoral component. Hip Int J Clin Exp Res Hip Pathol Ther 26(1):62–66Google Scholar
- 20.Langlais F (2002) Major reconstructions of the hip by allograft composite prostheses (long-term follow-up of 34 cases). Bull Acad Natl Med 186(3):661–677; discussion 677–681Google Scholar
- 26.Qu H, Guo W, Yang R, Tang X, Yan T, Li D et al (2015) Cortical strut bone grafting and long-stem endoprosthetic reconstruction following massive bone tumour resection in the lower limb. Bone Joint J 97-B(4):544–549Google Scholar