Endoprosthetic replacement of distal femoral tumors in Nigeria: A case series

In this observational study, three consecutive patients who were treated for distal femur tumours using endoprosthetic replacement between June 2013 and June 2014 were studied. The patients were within the ages of 28-47 years at the time of surgery. All three patients had modular endoprosthesis fixation and were evaluated using the Musculoskeletal Tumour Society (MSTS) Scoring System. Numerical values from 0 to 5 points were assigned for each of the following 6 categories: pain, function, emotional acceptance, use of supports, walking ability and gait. These values were added and the functional score was presented as a percentage of the maximum possible score. The results for each patient were graded according to the following scale: Excellent u 75-100%; good u 70-74%; moderate u 60-69%; fair u 50-59% and poor - 50%. Of the 3 patients evaluated, 2 had a diagnosis of Giant Cell Tumour (GCT) of the distal femur; the third patient was diagnosed to have plasmacytoma. All underwent wide local resection with modular endoprosthetic distal femur reconstruction. The MSTS functional scores calculated were 70%, 78%, and 52% respectively. Complications noted included wound dehiscence in two patients and thrombosis of the Pulmonary artery needing an arterial embolectomy in one of these two patients. The same patient also had a post-operative loss of motor and sensory function below the level of the ankle.