Background: The hip joint is a common location for metastatic
disease. Actual as well as impending fractures at this site are frequently due
to mechanical instability after tumor invasion and are usually treated
surgically with hip arthroplasty. The objective of this study was to analyze
survival and influences on survival after hip arthroplasty for metastatic hip
Methods: Two hundred and ninety-nine patients who had undergone a
total of 306 hemiarthroplasty or total hip arthroplasty procedures for
treatment of a pathologic or an impending pathologic hip fracture between 1969
and 1996 at our institution were included in this study. Data that had been
acquired prospectively within the total joint registry of our institution were
Results: The median duration of survival after the arthroplasty was
8.6 months. The duration of survival was significantly associated with the
site of the fracture, location of the primary tumor, and time from the
diagnosis of the primary tumor to the surgery for the fracture (p = 0.05).
The time from the diagnosis to the arthroplasty was a significant independent
predictor of survival.
Conclusions: Patients undergoing hip arthroplasty for metastatic
disease have a limited life expectancy, with only 40% (120) of the 299
patients in our series still alive at one year after the surgery. By
identifying prognostic factors regarding life expectancy, this study provides
surgeons and oncologists with information with which to weigh risks and
benefits of hip arthroplasty for individual patients preoperatively.
Level of Evidence: Prognostic study, Level II-1
(retrospective study). See Instructions to Authors for a complete description
of levels of evidence.