Главная Тезисы Особенности эндопротезирования суставов Subchondral endoprosthesis of proximal femur with malignant tumors

Subchondral endoprosthesis of proximal femur with malignant tumors

The saving of limbs and its functions at malignancies of the head, intercondilar of area of femur remains the problem. Any operation in such events can be considered only as palliative. She can be in the manner of one pale endoprosthesis, all-out endoprosthesis and subchondral endoprosthesis (each has their own evidences and contraindications). The general is radical removing of the tumor.

In 8 patients we realized the safe operation subchondral endoprosthesis. They were 5 man and 3 women at age from 46 before 77 years. The nosological form of the malignancies: osteogenic sarkoma-1, synovial sarkoma-1, malignant fiber gystiocytoma-1, metastasis of the cancer (the mamma, kidneys, prostates, lungs)-5.

The indications for subchondral endoprosthesis:

  1. tumor does not spread on head of the femur;
  2. the cortical layer of head is safe;
  3. tumor did leave the first muscular layer.

The methods of subchondral endoprosthesis: 1) the ablastic removing of the tumor; 2) excision before subchondral plate spongions bone tissue of the head; 3) processing to bone cavity by electric coagulation; 4) the fixing of endoprosthesis drumsticks inside the femur diaphysis; 5) filling of the cavity by fluid bone cement; 6) submersion of the endoprosthesis joint end diaphysis to fluid cement in the cavity of head; 7) reconstruction (as far as possible) of the joint capsule; 8) coverture of endoprosthesis by soft tissues; 8) the drainage of wound.

After operation 6 patients allived, 1,7-1,9 months-2,6-8 months-4. 3 patients have died at the first 6 months after operation, 2 - from cardiovascular insufficiency, one from continued tumors and metastasis growth in other organs. In three weeks after operation patients can walk with crutches, in month - with stick or with one crutch, in two months - free, without additional full tilts.

Babosha V.A., Chirakh E.S. R&D Institute of Traumatology and Orthopedics of Donetsk State Medical University named after M. Gorky, Donetsk, Ukraine

 

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