PROSTHETIC HIP-REPLACEMENT FOR PATHOLOGICAL OR IMPENDING PATHOLOGICALFRACTURES IN MYELOMA

The authors retrospectively reviewed 53 hip replacements performed in 50 patients (mean age, 65 years) for plasmacytoma (four lesions) or mu ltiple myeloma (49 lesions) of the hip region, Perioperatively, 49 pat ients received chemotherapy, Twenty-four hip lesions had radiation the rapy, Within a mean followup period of 32.6 months, 15 (28%) complicat ions occurred, Late deep infection, dislocation, and aseptic loosening with medial migration of the acetabular component occurred in one pat ient each, Three patients died during the first postoperative month, A ll of the remaining patients postoperatively regained their previous a mbulatory status; hip pain relief was achieved in 98% of patients, At the time of the latest followup evaluation, 84% of the patients had di ed (median survival time, 18 months) and 16% were still alive (median survival time, 76 months), Patients with plasmacytoma had longer survi val than did patients with multiple myeloma (median survival, 6.3 year s versus 18 months, respectively). No significant association was foun d between patient survival and the stage of disease at diagnosis, age, gender, type or location of the myeloma lesion, or the type of implan t used, Because of the relatively long survival time, prosthetic repla cement is indicated for extensive hip lesions in patients with plasmac ytoma or multiple myeloma.