Do cemented standard-length femoral stems have enough longevity for the pathological fractures of the femoral neck with metastatic lesions? A retrospective study

Abstract

Background Cemented long-stem hip arthroplasty is a treatment of choice for the pathological fractures of the femoral neck with metastatic lesions and the prevention of further fracture caused by metastasis progression. Objective The present study was an evaluation of the outcome after treatment of metastatic femoral neck fractures with cemented standard-length hemiarthroplasty. Methods We retrospectively studied 23 patients in whom the pathological fractures of the femoral neck with metastatic lesions were diagnosed. All patients underwent hemiarthroplasty with cemented standard-length femoral stems. The demographic data of the patients and clinical outcomes were obtained from an electronic medical database. Metastasis progression-free survival time was analyzed via the Kaplan–Meier curve. Results The mean age of the patients was 51.5 ± 11.7 years. The median duration of follow-up was 6.8 months (interquartile range, 5–22.6 months). Four patients exhibited tumor progression according to radiographic evaluation, but no patients had new fractures in the same bone or needed reoperation. The Kaplan–Meier curve revealed that 88.2% (74.2,100) of femurs demonstrated 1 year radiographic progression-free survival and 73.5% (49.4,100) demonstrated 2 year progression-free survival. Conclusions Our study demonstrated that the use of cemented standard-length stems in hemiarthroplasty for pathological fractures of the femoral neck with metastatic lesions is safe, and the rate of reoperation was low. We believe that this prosthesis is optimum for treatment in this group of patients because the length of survival in patients is expected to be short and the rate of metastasis progression in the same bone is low.