{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:00:56Z","timestamp":1759730456130},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Ministry of Science and ICT","award":["50549-2020"],"award-info":[{"award-number":["50549-2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The proximal femur is a common site for primary sarcomas and metastatic lesions. Although the early results of tumor prostheses are promising, the long-term results of reconstruction are unknown. The purpose of this study is to evaluate the prognostic factors affecting prosthesis survival and complications after proximal femoral resection and reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the results of 68 patients who underwent proximal femoral resection and reconstruction with a modular bipolar-type tumor prosthesis between 2005 and 2017. The mean follow-up was 55.6\u00a0months (range 6\u2013172\u00a0months). There were 50 male and 18 female patients with a mean age of 41.5\u00a0years (range 11\u201380\u00a0years). Cumulative survival analysis was performed to analyze the risk factors of prosthesis survival. We also evaluated the complications after operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen (21%) patients required further surgery at a mean 37\u00a0months post-operatively (range 5\u2013125\u00a0months). There were three cases of infection (4%), six of local recurrence (9%), three of acetabular erosion (4%) and two of stem loosening (3%). The implant survival rates were 83.9% at 5\u00a0years and 59.8% at 10\u00a0years. Prosthesis survivals did not differ based on fixation method (P\u00a0=\u00a00.085), age (P\u00a0=\u00a00.329) or resection length (P\u00a0=\u00a00.61). Acetabular chondrolysis was identified in 18 (26%) patients and longer resection length (\u226520\u00a0cm) showed a trend for risk of acetabular wear (P\u00a0=\u00a00.132).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results of proximal femoral resection and reconstruction with a modular bipolar-type prosthesis were found to be acceptable with infection and local recurrence as short-term complications and loosening and acetabular erosion as long-term complications.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jjco\/hyab087","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T11:24:01Z","timestamp":1622028241000},"page":"1248-1252","source":"Crossref","is-referenced-by-count":3,"title":["Clinical outcomes of endoprosthetic reconstruction for proximal femoral resection"],"prefix":"10.1093","volume":"51","author":[{"given":"Yongsung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae-Geun","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan Hyeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Bae","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Seok","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"key":"2021080204312382800_ref1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00003086-199901000-00003","article-title":"Endoprosthetic replacement for primary malignant tumors of the proximal femur","volume":"358","author":"Kabukcuoglu","year":"1999","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref2","first-page":"461","article-title":"Surgical treatment for metastatic disease of the pelvis and the proximal end of the femur","volume":"49","author":"Damron","year":"2000","journal-title":"Instr Course Lect"},{"key":"2021080204312382800_ref3","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1302\/0301-620X.88B6.17519","article-title":"Survivorship and clinical outcome of modular endoprosthetic reconstruction for neoplastic disease of the lower limb","volume":"88","author":"Ahlmann","year":"2006","journal-title":"J Bone Joint Surg Br"},{"key":"2021080204312382800_ref4","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.1007\/s11999-010-1369-6","article-title":"How long do endoprosthetic reconstructions for proximal femoral tumors last?","volume":"468","author":"Bernthal","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref5","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/01.blo.0000229332.91158.05","article-title":"Endoprosthetic reconstruction for neoplasms of the proximal femur","volume":"450","author":"Menendez","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref6","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1302\/0301-620X.91B3.21666","article-title":"Unipolar proximal femoral endoprosthetic replacement for tumour: the risk of revision in young patients","volume":"91","author":"Chandrasekar","year":"2009","journal-title":"J Bone Joint Surg Br"},{"key":"2021080204312382800_ref7","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/BLO.0b013e31804f5474","article-title":"Bipolar proximal femoral replacement prostheses for musculoskeletal neoplasms","volume":"459","author":"Finstein","year":"2007","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref8","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/00003086-200006000-00027","article-title":"Reconstruction of hip stability after proximal and total femur resections","volume":"375","author":"Bickels","year":"2000","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref9","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1302\/0301-620X.91B1.20448","article-title":"Modular endoprosthetic replacement for tumours of the proximal femur","volume":"91","author":"Chandrasekar","year":"2009","journal-title":"J Bone Joint Surg Br"},{"key":"2021080204312382800_ref10","doi-asserted-by":"crossref","first-page":"418","DOI":"10.2106\/JBJS.J.00834","article-title":"Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review","volume":"93","author":"Henderson","year":"2011","journal-title":"J Bone Joint Surg Am"},{"key":"2021080204312382800_ref11","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/00003086-199301000-00035","article-title":"A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system","volume":"286","author":"Enneking","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref12","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.2106\/00004623-200612000-00004","article-title":"Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial","volume":"88","author":"Baker","year":"2006","journal-title":"J Bone Joint Surg Am"},{"key":"2021080204312382800_ref13","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00590-016-1764-0","article-title":"Reconstruction of the proximal femur with a modular resection prosthesis","volume":"26","author":"Calabr\u00f3","year":"2016","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"2021080204312382800_ref14","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1007\/s11999-015-4282-1","article-title":"Total Femur Replacement After Tumor Resection: Limb Salvage Usually Achieved But Complications and Failures are Common","volume":"473","author":"Sevelda","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref15","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1002\/jso.20628","article-title":"Local recurrence and local control of non-metastatic osteosarcoma of the extremities: a 27-year experience in a single institution","volume":"96","author":"Bacci","year":"2007","journal-title":"J Surg Oncol"},{"key":"2021080204312382800_ref16","doi-asserted-by":"crossref","first-page":"216","DOI":"10.4055\/cios.2013.5.3.216","article-title":"Role of surgical margin on local recurrence in high risk extremity osteosarcoma: a case-controlled study","volume":"5","author":"Jeon","year":"2013","journal-title":"Clin Orthop Surg"},{"key":"2021080204312382800_ref17","doi-asserted-by":"crossref","first-page":"842","DOI":"10.2106\/JBJS.C.01222","article-title":"Periprosthetic infection in patients treated for an orthopaedic oncological condition","volume":"87","author":"Jeys","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"2021080204312382800_ref18","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.ejso.2018.12.009","article-title":"Silver-coated (Agluna(R)) tumour prostheses can be a protective factor against infection in high risk failure patients","volume":"45","author":"Parry","year":"2019","journal-title":"Eur J Surg Oncol"},{"key":"2021080204312382800_ref19","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00590-018-2270-3","article-title":"Silver-coated megaprostheses in the proximal femur in patients with sarcoma","volume":"29","author":"Streitbuerger","year":"2019","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"2021080204312382800_ref20","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/(SICI)1096-9098(199902)70:2<109::AID-JSO9>3.0.CO;2-X","article-title":"Relationship between magnitude of resection, complication, and prosthetic survival after prosthetic knee reconstructions for distal femoral tumors","volume":"70","author":"Kawai","year":"1999","journal-title":"J Surg Oncol"},{"key":"2021080204312382800_ref21","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/01.blo.0000181491.39048.fe","article-title":"Endoprosthetic and allograft-prosthetic composite reconstruction of the proximal femur for bone neoplasms","volume":"442","author":"Farid","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref22","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/00003086-200112000-00030","article-title":"Soft tissue reconstruction of megaprostheses using a trevira tube","volume":"393","author":"Gosheger","year":"2001","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref23","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1302\/0301-620X.97B12.36366","article-title":"The radiological evaluation of the hip joint after prosthetic arthroplasty of the proximal femur in patients with a tumour using a bipolar femoral head","volume":"97-B","author":"Drexler","year":"2015","journal-title":"Bone Joint J"},{"key":"2021080204312382800_ref24","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1302\/0301-620X.100B1.BJJ-2017-0005.R1","article-title":"Hemiarthroplasty proximal femoral endoprostheses following tumour reconstruction: is acetabular replacement necessary?","volume":"100-B","author":"Stevenson","year":"2018","journal-title":"Bone Joint J"},{"key":"2021080204312382800_ref25","doi-asserted-by":"crossref","first-page":"2692","DOI":"10.1016\/j.arth.2019.06.014","article-title":"Acetabular erosion after bipolar hemiarthroplasty in proximal femoral replacement for malignant bone tumors","volume":"34","author":"Theil","year":"2019","journal-title":"J Arthroplasty"},{"key":"2021080204312382800_ref26","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.arth.2005.05.005","article-title":"High failure rate of a constrained acetabular liner in revision total hip arthroplasty","volume":"20","author":"Della Valle","year":"2005","journal-title":"J Arthroplasty"},{"key":"2021080204312382800_ref27","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1302\/0301-620X.88B7.17644","article-title":"A constrained acetabular component for recurrent dislocation","volume":"88","author":"Khan","year":"2006","journal-title":"J Bone Joint Surg Br"},{"key":"2021080204312382800_ref28","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1007\/s11999-011-2212-4","article-title":"Constrained cups appear incapable of meeting the demands of revision THA","volume":"470","author":"Noble","year":"2012","journal-title":"Clin Orthop Relat Res"},{"key":"2021080204312382800_ref29","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1302\/0301-620X.101B5.BJJ-2018-1106.R1","article-title":"Mechanisms of failure and survival of total femoral endoprosthetic replacements","volume":"101-B","author":"Medellin","year":"2019","journal-title":"Bone Joint J"},{"key":"2021080204312382800_ref30","doi-asserted-by":"crossref","first-page":"180","DOI":"10.5312\/wjo.v5.i3.180","article-title":"Dual mobility cups in total hip arthroplasty","volume":"5","author":"De Martino","year":"2014","journal-title":"World J Orthop"},{"key":"2021080204312382800_ref31","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s00264-017-3407-4","article-title":"The dual mobility cup in muscular skeletal oncology: rationale and indications","volume":"41","author":"Zoccali","year":"2017","journal-title":"Int Orthop"},{"key":"2021080204312382800_ref32","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.otsr.2009.10.015","article-title":"Dual mobility design use in preventing total hip replacement dislocation following tumor resection","volume":"96","author":"Philippeau","year":"2010","journal-title":"Orthop Traumatol Surg Res"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/51\/8\/1248\/39503345\/hyab087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/51\/8\/1248\/39503345\/hyab087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T16:46:20Z","timestamp":1672245980000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/51\/8\/1248\/6294797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,8]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,6,8]]},"published-print":{"date-parts":[[2021,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyab087","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8]]},"published":{"date-parts":[[2021,6,8]]}}}