Total Massive Hip Prosthesis for Tumors of Upper Femur Analysis of Twenty Cases

Summary

Twenty cases of total massive hip replacement are analyzed. Of the 20 tumors, 15 had primary malignant bone disease and the site of occurrence was always the upper end of the femur. The mean length of femoral resection was 16 cm. The prosthesis used was mainly the Cochin type with a 32-mm head and a short lever arm. After resection, the range of follow-up was 1–10 years with an average of 4.5 years. Twelve patients remain free from disease and two have been lost to follow-up. According to Enneking’s classification, the functional results are as follows: four are excellent, 11 are good, four are fair, and one is poor. The best stability of the hip was obtained when it was possible to conserve the lateral part of the trochanter with the attachment of muscles. After the procedure, hip immobilization with a plaster cast seems to reduce the risk of dislocation. The behavior of the prosthesis is discussed according to the bone resorption around the stem of the prosthesis and X-ray signs on the acetabular component.