Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2016; 7(7): 442-447
Published online Jul 18, 2016. doi: 10.5312/wjo.v7.i7.442
Trochanter/calcar preserving reconstruction in tumors involving the femoral head and neck
Hwan Seong Cho, Young-Kyun Lee, Yong-Chan Ha, Kyung-Hoi Koo
Hwan Seong Cho, Young-Kyun Lee, Kyung-Hoi Koo, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea
Yong-Chan Ha, Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul 156-755, South Korea
Author contributions: Lee YK designed and performed the research and wrote the paper; Koo KH designed the research and supervised the report; Cho HS designed the research and contributed to the analysis; Cho HS, Lee YK, Ha YC and Koo KH provided clinical advice.
Institutional review board statement: The design and protocol of this retrospective study were approved by the institutional review board in Seoul National University Bundang Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Young-Kyun Lee, MD, Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam 463-707, South Korea. ykleemd@gmail.com
Telephone: +82-31-7877204 Fax: +82-31-7874056
Received: March 3, 2016
Peer-review started: March 4, 2016
First decision: April 15, 2016
Revised: April 22, 2016
Accepted: May 10, 2016
Article in press: May 11, 2016
Published online: July 18, 2016
Abstract

AIM: To evaluate the results of hip reconstruction with extensive excision for tumor confined to the femoral head and neck.

METHODS: We designed a resection preserving the greater trochanter and lower portion of calcar femorale, and utilized conventional total hip prosthesis. We retrospectively reviewed 7 patients, who underwent a wide resection and reconstruction using conventional hip prosthesis. There were 3 men and 4 women and their mean age was 42.5 years (22 to 65 years). The histologic diagnosis of each patient was low-grade osteosarcoma, diffuse large B-cell lymphoma, liposclerosing myxofibroma, intraosseous lipoma, chondroblastoma, giant cell tumor and focal intramedullary fibrosis.

RESULTS: One patient with lymphoma died due to disease dissemination at 10 mo postoperatively and the remaining 6 patients were followed for a mean of 4.7 years (3 to 6 years). All patients were able to return to their daily activities and no patient had local recurrence. No radiographic signs of loosening, wear, and osteolysis were found at the last follow-up.

CONCLUSION: Trochanter/calcar-preserving resection of the proximal femur and reconstruction using conventional total hip prosthesis, is a satisfactory treatment for tumors confined to the femoral head and neck.

Keywords: Total hip arthroplasty, Reconstruction, Tumor, Femoral head

Core tip: This is a retrospective study to evaluate the results of trochanter and calcar preserving reconstruction in tumors involving the femoral head and neck. While usual osteotomy for primary total hip arthroplasty is made straightly at 0.5 inch above the lesser trochanter, we made a curved osteotomy in coronal plane from the tip of greater trochanter to lower level or below the lesser trochanter to remove the tumor lesion confined to femoral head and neck. This technique can preserve the greater trochanter and lower portion of the calcar femorale. This surgical technique is a satisfactory treatment for tumors confined to the femoral head and neck.