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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 3, 401-404.
doi: 10.1302/0301-620X.91B3.21666  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Unipolar proximal femoral endoprosthetic replacement for tumour

THE RISK OF REVISION IN YOUNG PATIENTS

C. R. Chandrasekar, FRCS, Orthopaedic Surgeon1; R. J. Grimer, FRCS, Consultant Orthopaedic Oncologist1; S. R. Carter, FRCS, Consultant Orthopaedic Oncologist1; R. M. Tillman, FRCS, Consultant Orthopaedic Oncologist1; A. Abudu, FRCS, Consultant Orthopaedic Oncologist1; and L. M. Jeys, FRCS, Consultant Orthopaedic Oncologist1

1 Royal Orthopaedic Hospital, Bristol Road South, Birmingham B31 2AP, UK.

Correspondence should be sent to Mr R. J. Grimer; e-mail: rob.grimer{at}roh.nhs.uk

We undertook a cemental unipolar proximal femoral endoprosthetic replacement in 131 patients with a mean age of 50 years (2 to 84). Primary malignant tumours were present in 54 patients and 67 had metastatic disease. In addition, eight patients had either lymphoma or myeloma and two had non-oncological disorders. The mean follow-up was 27 months (0 to 180). An acetabular revision was required later in 14 patients, 12 of whom had been under the age of 21 years at the time of insertion of their original prosthesis. The risk of acetabular revision in patients over 21 years of age was 8% at five years compared with 36% in those aged under 21 years. All the unipolar hips in this younger age group required revision within 11 years of the initial operation.

We conclude that unipolar replacement should not be used in younger patients and should be avoided in patients with a life expectancy of more than five years.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General