Published online Jul 18, 2016. doi: 10.5312/wjo.v7.i7.442
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
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.
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.