A meta-analysis of 1,047 patients found that both intramedullary (IM) nailing and endoprosthetic (EP) reconstruction are effective options for treating femoral metastases, with the best choice depending on patient survival outlook and treatment goals.
The study showed that IM nailing is associated with fewer early complications, including lower infection rates and fewer reoperations within the first six months. It is generally preferred for patients with shorter life expectancy who need a less invasive procedure and faster recovery.
Endoprosthetic reconstruction, on the other hand, provides better long-term durability and fewer late reoperations. It is better suited for patients expected to live longer or those with extensive bone damage requiring stronger structural support.
Overall, complication rates such as implant failure were similar between the two approaches, but each had different timing advantages. The findings highlight the importance of individualized surgical planning in patients with cancer-related bone metastases, especially as modern cancer therapies continue to extend survival.