Function, disability, and health-related quality of life after allograft-prosthesis composite reconstructions of the proximal femur

Background: Factors affecting function, disability and health-related quality of life after allograft-prosthesis composite reconstructions have been poorly studied. Methods: Retrospective study of eighteen patients who underwent reconstruction with proximal femoral allograft-prosthesis composites and answered questionnaires to assess hip function (Postel and Merle d'Aubigne, self-reported Harris Hip Score), disability (Toronto Extremity Salvage Score), and health-related quality of life (SF-36). Results: The median Toronto Extremity Salvage Score was 76 (IQR: 48-85), the median self-reported Harris Hip Score was 90 (IQR: 48-95) and the median Postel and Merle d'Aubigne score was 17 (IQR: 12-17). Older age, female gender, and presentation with a pathologic fracture were associated with increased disability and poorest function. The median Physical Component Summary score was 44 (IQR: 39-45) and Mental Component Summary scores were 49 (IQR: 46-56). Male gender and recurrence of disease were associated with poorer health-related quality of life. There was a high degree of correlation between function, disability scores and Physical Component Summary score. Conclusions: Patients' characteristics at presentation such as age, gender, and occurrence of a pathologic fracture play an important role in determining disability, function, and health-related quality of life after allograft-prosthesis composite reconstruction of the proximal femur.