Reconstruction of large bone defects with arthroplasty in the treatment of bone tumors of the hip joint.

Background. In a retrospective study of the time of survival, the quality of life and the methods used to reconstruct large bone defects around the hip joint, we examined 13 patients treated surgically in our orthopedic ward between 1989 and 2004 for primary and secondary bone tumors. Material and methods. The study group included 11 women and 7 men, mean age 56.4 years. 5 patients (22%) had primary tumors: myeloma in 2 patients, chondrosarcoma in 2 patients, and MFH in 1 patient. In 13 patients (87%) there were metastatic lesions. The technical solutions used to reconstruct large bone defects included post-resection endoprothesis in 5 cases, total endoprothesis in 10 cases, and partial endoprosthesis in 3 cases. The treatment outcome was evaluated using the authors' own clinical scoring system, which covers pain, range of motion, muscle strength, ambulation, and activities of daily living. Results. There were no deaths in the early post-operative period. The mean post-operative follow-up time was 15 months. Excellent or good outcomes were achieved in 92.3% of cases: good ambulation, independence in activities of daily living, and no pain. The mean time of patient survival was 16.5 months (range: 10-42 months). Conclusions. Surgical reconstruction of large bone defects due to a malignant tumor around the hip joint is very effective in relieving pain, improving ambulation and increasing daily activities. The time of survival of patients after resection of bone tumor and hip replacement confirms the usefulness of this treatment method.