The Role of Intramedullary Nailing and Arthroplasty in the Treatment of Metastatic Carcinoma of the Proximal Femur: A Propensity Score-Matched Study

Objectives: To investigate the selection, clinical efficacy and prognosis of surgical treatment for proximal femoral metastases and compare the effectiveness of the intramedullary nail and joint replacement to treat proximal femoral metastases.Methods: This study retrospectively enrolled 60 patients with proximal femur metastases treated from 2006 to January 2016. Outcomes among patients of the two surgical methods by collecting medical records, intraoperative blood loss, operative time, VAS score, MSTS score, ECOG score, postoperative complications, and overall survival time.RESULTS: The amount of bleeding and the average operation time were significantly different in the nailing group and the hip replacement group. The postoperative VAS score, MSTS score, and ECOG score were also significantly different.CONCLUSION: Intramedullary nailing is preferred for patients with a short survival time, and a better quality of life is achieved early in patients with a limited survival time. Hip replacement is appropriate for patients who are expected to have a long survival time.