Proximal Femur Prosthetic Replacement

It is a procedure that involves removing a tumor (usually malignant or benign aggressive) of the upper leg bone (femur) and in most instances replacing the bone and hip joint with a special customizable proximal femur tumor prosthesis.

Prox Femur Xr2

What is Limb-Sparing Surgery of the Upper Femur/Hip?

The hip consists of your femur and pelvis. The pelvis is composed of three parts; the ischium, ilium, and pubis. The socket (hip joint) is called the acetabulum which forms the “cup.” The proximal (upper portion) femur and its diaphysis (middle portion) are common sites for primary bone sarcomas and metastatic tumors.  Some of these tumors include osteosarcomas, chondrosarcomas, and Ewing’s sarcomas. Limb-sparing surgery can be performed for approximately 95% of tumors arising from the upper femur. In some instances, the extremity cannot be saved and an amputation is performed. 

Contraindications for saving the limb may include neurovascular invasion, infection, pathological fracture, invasion of the pelvis, extensive disease, contamination from a poorly performed biopsy, recurrent disease.

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What’s involved in the technique?

What you can expect afterwards

After your surgery you will spend a few nights in the hospital and then will be recuperating at home. Various pain protocols and nerve blocks are used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. You will return to the office 2 weeks after surgery. Patients are usually kept in a hip abductor brace for 6 weeks to allow the surrounding muscles to heal and prevent dislocation of the hip by stabilizing the prosthesis. Once cleared, you will subsequently start physical therapy. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.

You will be monitored periodically with X-rays over the course of 5 years. Sometimes an MRI and/or CT may be used to additionally monitor the area to make sure the tumor has not come back. You will then have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year. Since the bone integrity has been restored to full or almost full, recovery is anticipated provided the patient adheres to strict physical therapy.

Types Of Physical Therapy

Proximal Femur Prosthetic Replacement 

Dr. James Wittig narrates a video illustrating the surgical technique for resection of the proximal femur and reconstruction utilizing a proximal femur tumor prosthesis. | WATCH VIDEO