Survivorship, Complications and Revisions Following Surgical Intervention for Femoral Metastasis: A Retrospective Study of 218 Patients

Mojahed Sakhnini
Orthopedics, Sheba Medical Center, Ramat Gan, Israel

Background: Femur is the most inflicted long bone by metastasis. Femoral fractures or impending fractures secondary to metastasis often require surgical intervention. This study compare survivorship, complication rate and revisions among different surgical modalities.

Purpose: to evaluate treatment outcome, survivorship and complications following treatment for metastatic femur fracture or impending fracture.

Methods: The study consists of 218 patients with femoral metastasis treated with surgical stabilization. The electronic medical records of all patients surgically treated for femoral metastasis were reviewed between 2004-2015. (n=130) patients underwent endoprosthetic reconstruction, (n=79) patients underwent nail reconstruction, (n=7) patients treated with ORIF , (n=2) patients underwent resection and cementation. The primary outcome was patient’s survivorship, Secondary outcomes were revision and 30-days systemic complications.

Results: the minimum follow up was 12 months. Mean, 66 months; range (12-140 months). 184 patients have died at the end of follow up. 11 Patients died within 30 days of surgery. Mean time for survivorship was 13.11 months. Range (0-102 months). Median, 7months. Postoperative complications included 4 dislocations of endoprosthetic reconstruction, 3 periprosthetic fracture, 9 infection of surgical wound, 11 pneumonia, 1 CVA, 2 MI, 7 PE, and 14 DVT. 12 patients underwent revision surgery during follow-up. Survival did not differ between surgical modalities (p=0.623).

Conclusion: several surgical modalities are available for treating femoral metastasis fracture or impending fracture. Survivorship are comparable among these surgical modalities.