Observational studyEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026
Clinical, functional, and quality-of-life outcomes after arthroplasty versus osteosynthesis for metastatic lesions of the proximal femur: a 12-month observational cohort study.
Observational study in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMetastatic lesions of the proximal femur frequently result in severe pain, impaired mobility, and pathological fractures. Surgical intervention aims to restore skeletal stability, allow early mobilization, and improve quality of life. This study compared clinical, functional, and quality-of-life outcomes following endoprosthetic reconstruction (arthroplasty) versus intramedullary osteosynthesis in patients with metastatic proximal femoral disease.
methodsThis single-center observational cohort study included 54 patients treated with either arthroplasty (n = 27) or intramedullary nail osteosynthesis (n = 27). Outcomes were assessed at 30 days, 6 months, and 12 months and included time to mobilization, SF-36 quality-of-life domains, the Bodily Pain score, functional mobility categories, Harris Hip Score (HHS), and postoperative complications.
resultsArthroplasty enabled significantly earlier mobilization (2.0 ± 0.79 vs. 5.7 ± 0.90 days; p < 0.001) and superior pain control (SF-36 Bodily Pain: 90 vs. 33; p < 0.001). Functional recovery was consistently better following arthroplasty, with higher independent ambulation rates and significantly higher HHS values at all follow-up points (12-month HHS: 78 ± 12 vs. 68 ± 16; p < 0.01). All SF-36 domains demonstrated statistically significant improvement in the arthroplasty group (all p < 0.001). Although overall complication rates were comparable (30 vs. 33 events), osteosynthesis showed a higher frequency of mechanical failures.
conclusionEndoprosthetic reconstruction was associated with earlier mobilization, improved pain control, better functional recovery, and higher quality-of-life scores compared with osteosynthesis in this cohort. These findings suggest that arthroplasty may represent a reliable reconstructive option for appropriately selected patients with metastatic lesions of the proximal femur.
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