Endoprosthetic replacement for giant cell tumour of the proximal femur

Abstract

Purpose. To evaluate the functional and oncological outcomes of 12 patients with giant cell tumour (GCT) of the proximal femur treated with customised endoprosthesis. Methods. Nine men and 3 women aged 26 to 52 (mean, 36) years with Campanacci stage-III GCTs of the proximal femur were included. All underwent a wide excision of the tumour with clear margins and replacement using a customised, bipolar, cemented proximal femoral megaprosthesis. Functional outcomes were evaluated using the Musculoskeletal Tumor Society functional scores. Results. The mean follow-up period was 4.8 (range, 4–6) years. There were no instances of recurrence, dislocation, aseptic loosening, deep infection, or death. At the end of 4 years, 8 patients were walking unassisted, 2 used a cane to support during outdoor activities, one used a walking frame at home and outdoors, and one was lost to follow-up. The mean pain relief score was 5.0, the mean functional score was 4.3, the mean emotional acceptance of the procedure and its outcome was 4.7, the mean lower extremity score for support use was 4.7, for walking ability was 4.5, and for gait was 4.3, and the mean total score was 28.3 (out of the maximum of 30). Conclusion. Endoprosthetic replacement for Campanacci stage-III GCT of the proximal femur achieves good to excellent functional and oncological outcomes.