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Long-term functional and radiological outcomes of allograft hip prosthesis composite. A fourteen -year follow-up study

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Abstract

Purpose

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).

Results

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.

Conclusion

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

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Abbreviations

APC:

Allograft hip Prosthesis Composite

AP:

anteroposterior

GT:

Greater Trochanter

MSTS:

MusculoSkeletal Tumor Society

PMA:

Postel-Merle d’Aubigne

RHA:

Revision Hip Arthroplasty

MRI:

Magnetic Resonance Imaging

vs.:

versus

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Acknowledgements

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.

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Authors and Affiliations

  1. Orthopaedic Department, Tumor and Spine Unit, Bicêtre University Hospital, AP-HP Paris, 78 rue du Général Leclerc, Le Kremlin-Bicêtre, France, F-94270

    Arnaud Dubory, Charles Court, Brice Viard & Gilles Missenard

  2. JE 2494 Univ Paris-Sud Orsay, F-01405, Orsay, France

    Arnaud Dubory, Charles Court, Brice Viard & Gilles Missenard

  3. Clinique Arago, 187 rue Raymond Losserand, Paris, France, 75014

    Eric Mascard

  4. Orthopaedic Department, Cochin University Hospital, AP-HP Paris, 27 rue du Faubourg Saint-Jacques, Paris, France, 75014

    Méryl Dahan & Philippe Anract

  5. Orthopaedic Department, University Hospital-Medical School Clermont-Ferrand, CHU Gabriel-Montpied, 58 rue Montalembert, Clermont-Ferrand, France, 63000

    Stéphane Boisgard

Authors
  1. Arnaud Dubory
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  2. Eric Mascard
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  3. Méryl Dahan
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  4. Philippe Anract
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  5. Charles Court
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  7. Brice Viard
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  8. Gilles Missenard
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Consortia

SOFCOT (The French Society of Orthopaedic and Trauma Surgery)

  • Arnaud Dubory
  • , Eric Mascard
  • , Méryl Dahan
  • , Philippe Anract
  • , Charles Court
  • , Stéphane Boisgard
  • , Brice Viard
  •  & Gilles Missenard

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Correspondence to Arnaud Dubory.

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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.

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Dubory, A., Mascard, E., Dahan, M. et al. Long-term functional and radiological outcomes of allograft hip prosthesis composite. A fourteen -year follow-up study. International Orthopaedics (SICOT) 41, 1337–1345 (2017). https://doi.org/10.1007/s00264-016-3351-8

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  • DOI: https://doi.org/10.1007/s00264-016-3351-8

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