Extended Anterior Approach for Proximal Femur Resection and Hip Reconstruction. Technique Description and Case Report of Three Oncologic Patients.

Abstract

This retrospective case report describes an extended anterior surgical approach for treating oncologic patients with proximal femur resection and hip reconstruction. Three consecutive women (mean age: 57.3; range: 33 to 81 years) with non-Hodgkins lymphoma (one case) or breast cancer (two cases) that had metastasized to the proximal femur underwent this procedure. Outcome measurements included timed-up-and-go, visual analog scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Independent walking distance was also recorded. At a mean of 14 months postoperatively, all three patients had returned to independent flat surface and stair ambulation with minimal hip pain. Normal active hip flexion and extension range of motion were also restored. All patients had ≥ 4/5 involved hip manual muscle test strength. The surgical approach we described enabled effective return to independent flat surface and stair ambulation.