Endoprosthetic reconstruction of the proximal femur in pediatric and adolescent patients with malignant tumors
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction. Limb-sparing surgeries with endoprosthetic hip joint reconstruction following proximal femoral resection in children and adolescents with malignant tumors pose a significant challenge both in terms of surgical treatment and rehabilitation. The limited number of publications focused on these patients, as well as the scarcity of available data on functional outcomes and complications, emphasizes the relevance of this study. Materials and methods. We retrospectively analyzed surgical outcomes in 61 patients aged 5 to 18 years who had undergone proximal femoral and hip joint endoprosthetic reconstruction at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology between January 2015 and February 2024. The median age was 13.79 years. The most common diagnoses were Ewing sarcoma (52,5%) and osteosarcoma (40,9%). Either proximal (68.9%) or total (31.1%) femoral endoprosthetic reconstructions with modular and expandable implants were performed. We analyzed functional outcomes using the MSTS score, assessed complication rates in accordance with the Henderson-ISOLS classification (2014), and evaluated implant “survival”. Results. The median MSTS score was 66% (53%; 77%), indicating good functional outcomes. Local recurrence was observed in 4.9% of the patients. Complications developed in 21.3% of the patients, with revision surgery required in 19.7% of cases. The 5-year overall “survival” of the endoprosthesis was estimated at 72%. The 2-year implant “survival” rate was higher with cementless fixation than with cemented fixation (92.5% vs. 78.9%; p = 0.04). Endoprosthesis “survival” was also found to be sex- and age-dependent. Conclusion. Endoprosthetic replacement following segmental resection of the proximal femur is an effective reconstructive approach in children and adolescents with malignant bone tumors, ensuring high functional restoration while resulting in acceptable complication rates. Modern modular and expandable endoprostheses allow for successful limb-sparing treatment even after extensive resections. These findings support the need for further data collection in order to optimize reconstructive strategies and prevent postoperative complications.
DOI: 10.24287/j.1150
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204272390