ArticleBMC musculoskeletal disorders2022
Intramedullary nailing vs modular megaprosthesis in extracapsular metastases of proximal femur: clinical outcomes and complication in a retrospective study.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Comparative evaluation of treatment strategies for femoral metastases: endoprosthesis reconstruction versus intramedullary nailing.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Photodynamic bone stabilization: a novel approach to elderly metastatic patients.Musculoskeletal surgery · 2026Review
- Remnant-preserving selective posterolateral bundle reconstruction for partial ACL tears: a retrospective comparative study of functional outcomes, graft maturation, and return-to-sport rates with and without biologic augmentation.BMC musculoskeletal disorders · 2026Article
- Comparative outcomes of internal fixation versus prosthetic reconstruction in the treatment of proximal femoral metastases: a systematic review and meta-analysis.EFORT open reviews · 2025Article
- Review
- Surgical management of metastatic lesions in the proximal femur: a systematic review.EFORT open reviews · 2025Article
- A comprehensive evaluation of intramedullary devices in the management of femoral metastasis: 30-day outcomes.Proceedings (Baylor University. Medical Center) · 2025Article
- Electrochemotherapy in the Treatment of Bone Metastases: A Systematic Review.Journal of clinical medicine · 2023Review
- Article
- Functional Outcomes and Shoulder Instability in Reconstruction of Proximal Humerus Metastases.Current oncology (Toronto, Ont.) · 2023Observational
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9 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundExtracapsular proximal femur metastasis could be treated by synthesis or resection and megaprosthesis. No universal accepted guidelines are present in the literature. The aim of our study is to analyze of patients with metastases in the trochanteric region of the femur treated by a single type of intramedullary nailing or hip megaprosthesis.
methodsWe retrospectively reviewed all patients affected by extracapsular metastases of proximal femur. Anthropometric and anamnestic data, routine blood exams and complications were collected. VAS score and MSTS score was administered before the surgery, ad 1-6-12 months after surgery. An un-paired T test and Chi-square were used. Multiple linear regression and logistic regression was performed. Significance was set for p < 0.05.
resultTwenty patients were assigned in intramedullary Group, twenty-five in megaprostheses Group. The mean operative time is shorter in intramedullary group. Differential shows a higher anemization in megaprostheses group (2 ± 2 vs 3.6 ± 1.3; p = 0.02). The patients of intramedullary group showed malnutrition (Albumin: 30.5 ± 6.5 vs 37.6 ± 6 g/L; p = 0.03) and pro-inflammatory state (NLR: 7.1 ± 6.7 vs 3.8 ± 2.4; p = 0.05) (PLR: 312 ± 203 vs 194 ± 99; p = 0.04) greater than megaprostheses group. The patients in intramedullary groups shows a higher functional performance score than megaprostheses group at 1 month follow-up (MSTS: 16.4 ± 6.3 vs 12.2 ± 3.7; p = 0.004). A multivariate analysis confirms the role of type of surgery (p = 0.001), surgery duration (p = 0.005) and NLR (p = 0.02) in affecting the MSTS. Globally eight complications were recorded, no statistical difference was noticed between the two groups (p = 0.7), no predictor was found at logistic analysis.
conclusionIntramedullary nailing guarantees a rapid functional recovery, compared to patients undergoing hip megaprosthesis who instead improve gradually over time. The selection of patients with poor prognosis allows the correct surgical indication of nailing, while in the case of a more favorable prognosis, the intervention of hip megaprosthesis is to be preferred.
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