An Overview on Complications of Proximal Femur Tumor Resection and Endoprosthetic Reconstruction

Abstract

The proximal femur is a common location for primary malignant and benign lesions as well as metastatic disease. It is the third localization for primary tumors after the distal femur and the proximal tibia and is the main localization for metastasis after the spine. In oncological hip surgery, obtaining a wide margin often means sacrificing important structures such as the joint capsule, the greater trochanter with the insertion of the gluteal muscles and the lesser trochanter with the insertion of the ileo-psoas muscle, with consequent joint instability. The incidence of instability of the hip after proximal femoral arthroplasty (PFA) using an endoprosthesis ranges from 1% to 37% and it is the most common mode of failure in several series. To overcome this problem and make soft tissue reattachment easier artificial band surrounding the implant has been recently introduced aiming to decrease the incidence of instability.