Cemented Bipolar Hemiarthroplasty as a Treatment Modality for Pathological Fracture in the Proximal Femur Metastasis Without the Recurrence of Primary Breast Cancer: A Case Report

TL;DR

A middle-aged woman with a history of breast cancer underwent a successful cemented bipolar hemiarthroplasty to treat a proximal femur metastasis without cancer recurrence.

Contribution

Demonstrates the effectiveness of cemented bipolar hemiarthroplasty for treating proximal femur metastasis without recurrence of primary breast cancer.

Findings

Cemented bipolar hemiarthroplasty provided a painless and functional joint for the patient.

The procedure eliminated the risk of acetabular component complications requiring early revision.

Modular bipolar hemiarthroplasty is associated with fewer complications and improved quality of life.

Abstract

Metastatic lesions in the proximal femur are well-known in the literature and are important since they can progress to pathological fractures and impair the patient's mobility. We present the case of a middle-aged female with a history of breast carcinoma 20 years ago, who experienced diffuse chronic hip pain for the past two months. Radiographs, MRI, and PET scans revealed a metastatic lesion in her proximal femur. After consulting with an oncologist, it was determined that adjuvant chemoradiotherapy was unnecessary. The treatment strategy was dependent on the preoperative general health condition, the life expectancy, amount of metastasis, bone quality, pathological fractures and factors affecting the union and capacity to ambulate the patient postoperatively. The patient underwent a cemented bipolar hemiarthroplasty to excise all metastatic tissue and provide a painless, functional, and mobile joint. Bipolar hemiarthroplasties articulate at two levels, and this dual-bearing design is believed to reduce acetabular wear. The bipolar hemiarthroplasty also eliminated the risk of complications associated with the acetabular component, which would necessitate early revision surgery. Modular bipolar hemiarthroplasty is a good modality of replacement associated with fewer complications and improves quality of life.

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