Early Functional Outcome Following Proximal Femur Tumor Resection and Endoprosthetic Reconstruction

Background: The proximal femur is a common site for aggressive primary and metastatic bone tumors. While limb-salvage surgery has become the standard of care, early functional outcomes following tumor resection and modular endoprosthetic reconstruction remain variably reported. Objective: To evaluate postoperative function, complication rates, and implant survival in patients undergoing this procedure. Patients and Methods: A retrospective analysis was conducted on 24 patients (mean age 36.5 years; range 14–66) who underwent proximal femur resection and modular endoprosthetic reconstruction between January 2022 and July 2023. Data collected included operative details, histopathology, Musculoskeletal Tumor Society (MSTS) scores, and postoperative complications. Follow-up averaged 23.2 ± 7.6 months. Results: Primary malignant tumors were the most prevalent (54.2%), followed by secondary malignancies (37.5%) and benign lesions (8.3%). The most frequent diagnoses were Ewing sarcoma (25%) and breast metastasis (16.7%). The mean operative time was 162.1 ± 33.6 minutes, and the mean blood loss was 864.6 ± 132.3 mL. The mean MSTS score was 19 ± 5.87, corresponding to 62.2% of the maximum possible functional score, with 79.2% of patients achieving good to excellent functional outcomes. Major complications included aseptic loosening and early infection (each 8.3%), while implant survival was 91.7%. Patient survival at final follow-up was 79.2%. Conclusions: Modular endoprosthetic reconstruction following proximal femur tumor resection offers reliable early functional recovery with acceptable complication and implant survival rates. This technique remains a cornerstone of modern limb-salvage surgery in musculoskeletal oncology.