{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:46:29Z","timestamp":1793213189787,"version":"4.5.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T00:00:00Z","timestamp":1644710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T00:00:00Z","timestamp":1644710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002352","name":"Ain Shams University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background and purpose<\/jats:title>\n                <jats:p>Proximal femur is a common site for metastasis, it has a significant impact on patient\u2019s quality of life, and traditional treatment aims at protecting as much as possible from the femur. However, recent studies have demonstrated increased rate of complications and questioned the need for long stem in this high-risk group. Our purpose is to determine whether standard-length femoral stem is noninferior to long femoral stem in the treatment of proximal femoral metastasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and methods<\/jats:title>\n                <jats:p>Between 2019 and 2021, we prospectively included 24 patients with proximal femoral metastasis leading either to impending or pathological fractures (5 and 19 cases, respectively). We included patients with lesions due to metastasis, lymphoma, or multiple myeloma. Patients were quasi-randomized based on their order of presentation into two groups based on the femoral stem length, cemented standard (group 1) and long (group 2) femoral stem. Oncological complications, survival, stem complications, and functional outcomes were recorded and analyzed using SPSS 25.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>24 patients were included in the final analysis, 13 case in group 1 and 11 in group 2, and mean age 57.6\u00a0years. Mean follow-up duration was 10\u00a0months, and 11 patients died of the whole-study population with mean survival of (10.85\u2009\u00b1\u20092.23, 8.82\u2009\u00b1\u20093.6) months in group 1, 2, respectively. The complication rate was higher in the standard group; however, this difference did not reach statistical significance. No difference was found between study groups regarding functional outcomes, except for VAS at 6\u00a0months which was higher in standard group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We believe that the ubiquitous use of long stem in the management of proximal femoral metastasis should be questioned considering the expected patient survival and low rate of complications associated with the use of standard stem.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinicaltrials.gov registration number<\/jats:title>\n                <jats:p>NCT04660591.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-021-01875-x","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T09:02:14Z","timestamp":1644742934000},"page":"2977-2985","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cemented long versus standard femoral stem in proximal femoral metastasis: a noninferiority single-blinded quasi-randomized clinical trial"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-6576","authenticated-orcid":false,"given":"Ibrahim Mahmoud","family":"Abdelmonem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif Ishak","family":"Azmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman Mohammad","family":"EL Masry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed k","family":"el ghazawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed sayed","family":"kotb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman Abdelaziz","family":"Bassiony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,13]]},"reference":[{"key":"1875_CR1","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/S0030-5898(05)70171-1","volume":"31","author":"WD Hage","year":"2000","unstructured":"Hage WD, Aboulafia AJ, Aboulafia DM. Incidence, location, and diagnostic evaluation of metastatic bone disease. Orthop Clin North Am. 2000;31:515\u201328.","journal-title":"Orthop Clin North Am"},{"key":"1875_CR2","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1590\/S1807-59322006000400007","volume":"61","author":"DK Narazaki","year":"2006","unstructured":"Narazaki DK, de Alverga Neto CC, Baptista AM, et al. Prognostic factors in pathologic fractures secondary to metastatic tumors. Clinics (Sao Paulo). 2006;61:313\u201320.","journal-title":"Clinics (Sao Paulo)"},{"key":"1875_CR3","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.jbo.2018.02.006","volume":"12","author":"TJ Reif","year":"2018","unstructured":"Reif TJ, Strotman PK, Kliethermes SA, et al. No consensus on implant choice for oligometastatic disease of the femoral head and neck. J Bone Oncol. 2018;12:14\u20138.","journal-title":"J Bone Oncol"},{"key":"1875_CR4","doi-asserted-by":"publisher","first-page":"6243s-9s","DOI":"10.1158\/1078-0432.CCR-06-0931","volume":"12","author":"RE Coleman","year":"2006","unstructured":"Coleman RE, Roodman S, et al. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12:6243s\u20139s.","journal-title":"Clin Cancer Res"},{"key":"1875_CR5","first-page":"107","volume":"8","author":"Z Yu","year":"2018","unstructured":"Yu Z, Xiong Y, Shi R, et al. Surgical management of metastatic lesions of the proximal femur with pathological fractures using intramedullary nailing or endoprosthetic replacement. Mol Clin Oncol. 2018;8:107\u201314.","journal-title":"Mol Clin Oncol"},{"key":"1875_CR6","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s12893-018-0336-0","volume":"18","author":"G Guzik","year":"2018","unstructured":"Guzik G. Oncological and functional results after surgical treatment of bone metastases at the proximal femur. BMC Surg. 2018;18:2\u20139.","journal-title":"BMC Surg"},{"key":"1875_CR7","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1016\/j.injury.2018.09.044","volume":"49","author":"A Angelini","year":"2018","unstructured":"Angelini A, Trovarelli G, Berizzi A, et al. Treatment of pathologic fractures of the proximal femur. Injury. 2018;49:S77\u201383.","journal-title":"Injury"},{"key":"1875_CR8","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1302\/0301-620X.87B12.16629","volume":"87","author":"R Wedin","year":"2005","unstructured":"Wedin R, Bauer HCF. Surgical treatment of skeletal metastatic lesions of the proximal femur. Endoprosthesis or reconstruction nail? J Bone Jt Surg Br. 2005;87:1653\u20137.","journal-title":"J Bone Jt Surg Br."},{"key":"1875_CR9","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1097\/01.blo.0000191270.50033.3a","volume":"443","author":"RL Randall","year":"2006","unstructured":"Randall RL, Aoki SK, Olson PR, Bott SI. Complications of cemented long-stem hip arthroplasties in metastatic bone disease. Clin Orthop Relat Res. 2006;443:287\u201395.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR10","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1097\/00003086-200202000-00017","volume":"395","author":"T Herrenbruck","year":"2002","unstructured":"Herrenbruck T, Erickson EW, Damron TA, Heiner J. Adverse clinical events during cemented long-stem femoral arthroplasty. Clin Orthop Relat Res. 2002;395:154\u201363.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR11","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1007\/s11999-013-2790-4","volume":"471","author":"Z Xing","year":"2013","unstructured":"Xing Z, Moon BS, Satcher RL, et al. A long femoral stem is not always required in hip arthroplasty for patients with proximal femur metastases tumor. Clin Orthop Relat Res. 2013;471:1622\u20137.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR12","unstructured":"MSTS, ASTRO, ASCO. The treatment of metastatic carcinoma and myeloma of the femur: Clinical practice guideline In Clinical Practice Guidelines. 2019. http:\/\/msts.org\/view\/download.php\/education\/mbd-cpg-amended. Accessed 13 Oct 2020."},{"key":"1875_CR13","doi-asserted-by":"publisher","first-page":"3303","DOI":"10.1007\/s11999-013-3113-5","volume":"471","author":"SL Price","year":"2013","unstructured":"Price SL, Farukhi MA, Jones KB, et al. Complications of cemented long-stem hip arthroplasty in metastatic bone disease revisited. Clin Orthop Relat Res. 2013;471:3303\u20137.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR14","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1007\/s11999-012-2656-1","volume":"471","author":"HM Alvi","year":"2013","unstructured":"Alvi HM, Damron TA. Prophylactic stabilization for bone metastases, myeloma, or lymphoma: do we need to protect the entire bone? Clin Orthop Relat Res. 2013;471:706\u201314.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR15","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1007\/s11999-016-4810-7","volume":"475","author":"JR Peterson","year":"2017","unstructured":"Peterson JR, Decilveo AP, O\u2019Connor IT, et al. What are the functional results and complications with long stem hemiarthroplasty in patients with metastases to the proximal femur? Clin Orthop Relat Res. 2017;475:745\u201356.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR16","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1007\/s11999-014-4064-1","volume":"473","author":"B Moon","year":"2015","unstructured":"Moon B, Lin P, Satcher R, et al. Intramedullary nailing of femoral diaphyseal metastases: is it necessary to protect the femoral neck? Clin Orthop Relat Res. 2015;473:1499\u2013502.","journal-title":"Clin Orthop Relat Res"},{"key":"1875_CR17","first-page":"1158","volume":"66","author":"K Sarahrudi","year":"2009","unstructured":"Sarahrudi K, Greitbauer M, Platzer P, et al. Surgical treatment of metastatic fractures of the femur: a retrospective analysis of 142 patients. J Trauma. 2009;66:1158\u201363.","journal-title":"J Trauma"},{"key":"1875_CR18","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.arth.2006.11.016","volume":"23","author":"H Selek","year":"2008","unstructured":"Selek H, Ba\u015farir K, Yildiz Y, Sa\u011flik Y. Cemented endoprosthetic replacement for metastatic bone disease in the proximal femur. J Arthroplasty. 2008;23:112\u20137.","journal-title":"J Arthroplasty"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-021-01875-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-021-01875-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-021-01875-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T14:10:00Z","timestamp":1659967800000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-021-01875-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,13]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["1875"],"URL":"https:\/\/doi.org\/10.1007\/s00068-021-01875-x","relation":{},"ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,13]]},"assertion":[{"value":"15 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"An informed consent was taken from all patients and an institutional review board approval was obtained from Ainshams university Hospital (FMASU MD 277\/ 2019).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical considerations"}},{"value":"Institutional review board approval was obtained, and informed consent, describing the procedure, the expected outcomes, and complications, was taken from all patients included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}