Calcar-Replacing Total Hip Replacement for a Giant Cell Tumor of the Proximal Femur: A Case Report and A Review of Literature

Juan Paulo Panti
2015 Orthopedic Research & Physiotherapy  
A 35 year old male truck driver had a 4 month history of intermittent, constricting pain of the right hip and groin area with a maximum VAS score of 6/10. The pain was present even at rest and Abstract Giant Cell Tumor of the bone (GCTb) is a relatively benign but locally aggressive tumor, capable of producing debilitating lytic bone lesions with a rare likelihood of producing lung metastases. The proximal femur is an uncommon location for its occurrence, with more than 50% of these
more » ... eal lesions occurring around the knee joint. The reported incidence of GCTb in the proximal femur is only reported to be around 3-4%. However, selecting the appropriate treatment is challenging due to the proximity with the hip joint, and the risk of damaging the insertion of several essential hip muscles. Joint-salvaging surgery primarily involves extended curettage, with or without adjuvant therapy, bone graft, or cement packing. Conversely, there is still considerable high recurrence rate even after extended curettage with cementing (0-29%). As such, hip replacement surgery is a suitable treatment for patients with pathologic fracture and for those with an extensive lesion of the proximal femur. We report our experience of a young patient with a pathologic femoral neck fracture, secondary to GCTb of the proximal femur. A calcar replacing stem was utilized since the tumor and surgical resection involved the lesser trochanter. Volume 1 • Issue 3 • 100012 calcar-replacing femoral stem was selected due to the involvement and possible excision of the calcar femorale and lesser trochanter.
doi:10.24966/orp-2052/100012 fatcat:53ffoz4nvzgx5kpp5idvcsbsdm