(P 106) REPAIR: A PRELIMINARY REPORT ON AN ONGOING MULTI-CENTER TRIAL FOR PATIENTS UNDERGOING SURGICAL STABILIZATION FOR METASTATIC BONE DISEASE OF THE FEMUR

Objective: In patients with metastatic bone disease (MBD), metastases to the bone frequently lead to catastrophic pathologic fractures of the femur, which are associated with significant morbidity. Although prophylactic stabilization is considered the standard preventive intervention for those at risk of pathologic fractures, there have been no studies prospectively evaluating the outcomes of this intervention.

Methods: Ongoing prospective multicenter observational study of patients undergoing prophylactic stabilization for impending pathologic femur fractures. PROMIS Pain Interference (PI) and Physical Function (PF) scores were collected preoperatively and at 1, 2, 4, 6, 10 weeks; 3, 6 months; and 1, 2 years postoperatively.

Results: A total of 61 patients were enrolled across eight institutions, with an average age of 64.6 years (SD 11.2) and BMI of 27 at the time of surgery. The cohort was predominantly white (79%), non-Hispanic or Latino (83.6%), and male (50.8%). The most common diagnosis was metastatic carcinoma in 72.9% of patients, and the most common lesion location was the proximal femur (74.6%). Most patients had received systemic therapy (63.2%) and radiation (54.2%) prior to surgery. Patients reported immediate improvement in pain at one week postoperatively, which continued up to one year. However, physical function scores continued to decline up to one year postoperatively (Table 1). Data on postoperative complications were available for 55 patients. There were 2 incidences of wound dehiscence (3.6%), 2 implant failures (3.6%), and 3 reoperations (5.4%).

Conclusion: Prophylactic stabilization of the femur for patients with MBD results in improved pain for up to 1 year postoperatively, while physical function continues to decline. This information is crucial when counseling patients and serves as a baseline for future randomized trials aimed at elucidating the optimal surgical approach to MBD in the femur.

Table 1. Average PROMIS scores after Prophylactic Femur Stabilization