Data from 44 patients (23 males, 21 females) with a median age of 39 (range 13-80) years who underwent total hip arthroplasty for proximal femoral tumours (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) were analysed. The histological diagnoses included 14 metastases, six osteosarcomas, six chondrosarcomas, four Ewing's sarcomas, four giant cell tumours, three malignant fibrous histiocytomas, two parosteal and two periosteal osteosarcomas, and one each primary neuroectodermal tumour, myeloid disease, and aneurysmal bone cyst. Twenty-one patients (48%) had pathological fractures. The cause of the pathological fracture was metastasis in 12 patients (57%). Twenty-eight patients (64%) had soft tissue invasion. Complications observed in 17 patients (37%) were local recurrence in two, postoperative haematoma in two, dislocation of prosthesis in five, deep infection in six, and one patient died of myocardial infarction in the early postoperative period. During our midterm survival analysis, functional results were excellent in 25% of patients, good in 57%, fair in 12%, and poor in 6%.Résumé Entre 1994 et 2004, nous avons récolté les données de 44 patients (23 hommes et 21 femmes), dont l'âge moyen était de 39 ans (de 13 à 80), qui ont bénéficié d'une prothèse totale de hanche pour une tumeur de l'extrémité proximale du fémur 4. Le diagnostic étiologi-que a inclus, chez ces patients, 14 métastases, 6 ostéosarcomes, 6 chondrosarcomes, 4 sarcomes d'Ewing, 4 tumeurs à cellules géantes, 4 histiocytomes malins, 2 sarcomes paraosteal, 2 sarcomes périosters et une tumeur neuroectodermique, un myélome un kyste anévrismal. 21 patients (48%) présentaient une fracture pathologique. La fracture pathologique était une métastase chez 12 patients (soit 57%). Pour 28 patients (64%) avaient un envahissement des parties molles. Des complications ont été observées chez 17 patients (37%) avec 2 récidives locales de la tumeur, 2 hématomes post-opératoires, 5 luxations de prothèse, 6 infections profondes et un patient décédé d'infarctus du myocarde en post opératoire précoce. Le résultat fonctionnel a été noté excellent à moyen terme chez 25 patients, bon chez 57%, moyen pour 12% et mauvais pour 6% des patients.

19508 Background: To analyse the five-year survival rate in patients with proximal femoral tumours after total hip replacement. Methods: Between the period of 1994–2003, 50 patients were operated (Total Hip Replacement) for proximal femoral tumours at the Department of General Oncology (Bone & Soft tissue tuomurs), N. N. Blokhin Cancer Research Institute & Moscow Regional Clinical Research Institute, Moscow, Russian Federation. The histological diagnoses included 14 - metastases, 10 - osteosarcoma, 8 - chondrosarcoma, 4 - Ewing’s sarcoma, 4 - Giant cell tumor, 3 - malignant fibrous histiocytoma, 2 paraosteal and 2 periosteal osteosarcoma, and 1 each from primary neuroectodermal tumor, myeloid disease, and aneurysmal bone cyst. The follow-up ranged from 1–9 years (mean follow-up 5 years). 21 patients (45.7%) had pathological fracture. The cause of the pathological fracture was metastasis in 12 patients (26%). 28 patients (60.8%), had soft tissue invasion. All the survival analyses were done using Kaplan-Meier survivorship analysis method. Functional outcome was estimated using Enneking’s evaluation criteria. Results: The overall survival rate of patients was 66.7% at 5 years. 2 patients had local recurrence.12 patients had metastases after surgery. In that 11 patients were died. There was no evidence of disease in 32 patients. In 3 patients, we performed disarticulation of the hip joint because of the local recurrence. The overall survival rate of limb was 92.7% at 5 years. The overall survival rate of prostheses was 84.2% at 5 years. At the latest follow up, functional outcome was excellent in 15 (30%) patients, good in 27 (54%) patients, fair in 5 (10%) patients, poor in 3 (6%) patients. Conclusions: Though the extent of the muscle and bone resection is large, there is no doubt that endoprosthetic replacement of the proximal femur provides a good functional and oncological outcome when compared with the various other reconstructive surgeries. No significant financial relationships to disclose.