Management of femoral bone loss in revision total hip arthroplasty

Peter K. Sculco, Matthew Abdel, David G. Lewallen

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

Femoral bone loss is frequently encountered during revision total hip arthroplasty. The quality and quantity of remaining bone helps determine the best method for reconstruction. Extensively porous-coated cylindrical stems or titanium fluted tapered devices that achieve fixation in the diaphysis have both demonstrated excellent long-term survivorship. Titanium fluted tapered stems with a modular proximal body allow for more accurate leg length, offset, and version adjustments independent of the distal stem which may optimise hip biomechanics. Intraoperative fractures are more common with cylindrical stems and subsidence with tapered stems, particularly monoblock designs and in both dislocation continues to be one of the most common postoperative complications. In salvage situations in which an ectatic femoral canal is unable to support an uncemented device, impaction bone grafting, allograft-prosthetic composite, or a segmental proximal femoral replacement may be required.

Original languageEnglish (US)
Pages (from-to)380-387
Number of pages8
JournalHIP International
Volume25
Issue number4
DOIs
StatePublished - Jul 1 2015

Keywords

  • Extensively porous-coated cylindrical stems
  • Femoral bone loss
  • Femoral revision
  • Revision total hip arthroplasty
  • Titanium modular fluted tapered stems

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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