No consensus on implant choice for oligometastatic disease of the femoral head and neck

Journal of Bone Oncology
Taylor J ReifLukas M Nystrom

Abstract

Metastatic disease involving the femoral head and neck is often treated with a hemiarthroplasty or total hip arthroplasty (THA) to prevent pathologic fracture but there are no outcome studies demonstrating superiority of one option over the other. This investigation was designed as a survey of the current members of the Musculoskeletal Tumor Society (MSTS). The survey contained seven clinical vignettes with identical imaging of a pathologic lesion of the femoral head and neck. The primary outcome measured was decision to treat the lesion with hemiarthroplasty or THA. Secondary outcomes included method of fixation of the femoral/acetabular components and head type utilized. A total of 93 members (30.0%) of the MSTS completed the survey. Across all clinical vignettes, 73.3% (p < 0.001) of the responses were in favor of hemiarthroplasty; however, there was no significant difference between hemiarthroplasty and THA in Cases 1 & 2 (p = 0.08, p = 0.6, respectively); the cases representing younger patients with a more favorable histologic diagnosis. When THA was selected the majority of respondents preferred hybrid or cementless fixation construct (56.1% and 27.0%, respectively, p < 0.001). When hemiarthroplasty was selected responden...Continue Reading

Citations

Aug 14, 2019·Journal of Surgical Oncology·Nathan H VaradyAntonia F Chen
May 20, 2020·Journal of Orthopaedics·Christopher G LarsenShachar Kenan
Sep 2, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Allison L BodenJuan Pretell-Mazzini
Aug 23, 2021·The Journal of Arthroplasty·Brett L HaydenUNKNOWN Pathologic Fracture Study Group

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Methods Mentioned

BETA
total hip arthroplasty
biopsy

Software Mentioned

SurveyMonkey®
Vignette
SAS

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