TITLE

Proximal Femoral Replacement in Patients with Non-Neoplastic Conditions

AUTHOR(S)
Parvizi, Javad; Tarity, T. David; Slenker, Nicholas; Wade, Frazier; Trappler, Rachel; Hozack, William J.; Sim, Franklin H.
PUB. DATE
May 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;May2007, Vol. 89-A Issue 5, p1036
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Numerous factors may give rise to the loss of femoral bone stock that can be encountered in revision hip arthroplasty. Proximal femoral replacement is an option for the treatment of severe proximal femoral bone loss. In this study, we sought to determine the outcome of reconstructive surgery with the use of a modular proximal femoral replacement (a so-called megaprosthesis) in patients with proximal femoral bone loss due to non-neoplastic conditions. Methods: A review of computerized databases from two institutions identified forty-eight patients with a mean age of 73.8 years who had undergone the placement of a modular megaprosthesis with or without bone-grafting. The indication for proximal femoral replacement was a periprosthetic fracture in twenty patients, reimplantation because of a deep infection in thirteen, a failed arthroplasty in thirteen, nonunion of an intertrochanteric fracture in one, and radiation-induced osteonecrosis with a subtrochanteric fracture in one. Three patients died before the minimum two-year follow-up interval had elapsed, and two additional patients were lost to follow-up. The mean duration of follow-up for the remaining study group of forty-three patients was 36.5 months. Results: At the time of follow-up, there was a significant improvement in function as measured with the Harris hip score (p < 0.05). The proximal femoral replacement achieved an excellent or good functional outcome in twenty-two of the forty-three hips. The functional outcome was found to be fair in ten hips and poor in the remaining eleven. Ten patients required a reoperation or revision because of at least one complication. With revision used as the end point, the survivorship of the implant was 87% at one year and 73% at five years. Conclusions: Patients with severely compromised bone stock in whom the use of a conventional prosthesis is precluded because of an inability to achieve adequate fixation may be candidates for proximal femoral replacement. Our short-term results suggest that this is a viable salvage procedure for these patients.
ACCESSION #
25019649

 

Related Articles

  • The initial fixation of the press-fit acetabular shell – clinical observation and experimental study. Kaneko, Kazuo; Inoue, Yukio; Yanagihara, Yasushi; Uta, Souichi; Mogami, Atsuhiko; Iwase, Hideaki // Archives of Orthopaedic & Trauma Surgery;May2000, Vol. 120 Issue 5/6, p323 

    The initial solid fixation of an uncemented acetabular component affects the amount of bone ingrowth. We had several problems with broken screws in cases of acetabular revision. In recent years, the development of uncemented components without screws has attempted to improve these problems. We...

  • The impact of waiting for total joint replacement on pain and functional status: a systematic review.  // Advances in Orthopaedics;Jun2010, Vol. 2 Issue 2, p74 

    In this systematic review, the authors assessed determinants of changes in pain and functioning in patients with osteoarthritis awaiting total joint arthroplasty.

  • Scintigraphic evaluation of impaction grafting for total hip arthroplasty revision. Mazhar Tokgözo&gcaron;lu, A.; Aydin, Mehmet; Atilla, Bülent; Caner, Biray // Archives of Orthopaedic & Trauma Surgery;Jul2000, Vol. 120 Issue 7/8, p416 

    To determine the fate of an impacted allograft after a minimum follow-up of 1 year, we examined 9 of 40 patients who underwent revision arthroplasty with the impaction grafting technique. The allograft used in this study was morselized cancellous freeze-dried allograft. We examined these 9...

  • The effect of patient position on blood loss in primary cemented total hip arthroplasty. Pace, Alistair; Yousef, Almunir // Archives of Orthopaedic & Trauma Surgery;Oct2008, Vol. 128 Issue 10, p1209 

    The total blood loss of 101 cemented primary total hip arthroplasties was studied in a prospective randomised study. Fifty of them were implanted in the supine position and 51 in the lateral position. The patients were matched for sex, height, weight and ASA grade. Only one surgeon carried out...

  • Optimizing success with lumbar disc arthroplasty. Gornet, Matthew; Schranck, Francine; Wharton, Nicholas; Beall, Douglas; Jones, Elizabeth; Myers, Mark; Hipp, John // European Spine Journal;Oct2014, Vol. 23 Issue 10, p2127 

    Purpose: This study aimed at determining the variables that may prove useful in predicting clinical outcomes following lumbar disc arthroplasty. Methods: Pre- and post-operative imaging assessments were obtained for 99 single-level lumbar disc arthroplasty patients from a prospective IDE study....

  • Athletic Activity After Total Joint Arthroplasty. Healy, William L.; Sharma, Sanjeev; Schwartz, Benjamin; Iorio, Richard // Journal of Bone & Joint Surgery, American Volume;Oct2008, Vol. 90-A Issue 10, p2245 

    The article presents an overview of medical concepts related to athletic activity after total joint arthroplasty which is performed to treat arthritis. A discussion of information which orthopedic surgeons should provide to patients who are considering athletic activity after arthroplasty is...

  • Percutaneously Assisted Total Hip Arthroplasty (PATH): A Preliminary Report. Penenberg, Brad L.; Bolling, W. Seth; Riley, Michelle // Journal of Bone & Joint Surgery, American Volume;Nov2008 Supplement 4, Vol. 90-A, p209 

    The article presents the results of research which was done in an effort to present a new soft tissue sparing approach to total hip arthroplasty. Researchers wanted to develop the approach, called percutaneously assisted total hip arthroplasty, so that patients undergoing arthroplasty would not...

  • The Effect of a Single Infusion of Zoledronic Acid on Early Implant Migration in Total Hip Arthroplasty: A Randomized, Double-Blind, Controlled Trial. Friedl, Gerald; Radl, Roman; Stihsen, Christoph; Rehak, Peter; Aigner, Reingard; Windhager, Reinhard // Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p274 

    Aseptic loosening is the most frequent cause of implant failure in total hip arthroplasty. While a direct link between aseptic loosening and periprosthetic bone loss remains elusive, there is plentiful evidence for a close association with early implant migration. The present trial was primarily...

  • "MINIMALLY INVASIVE" TOTAL HIP ARTHROPLASTY. Berry, Daniel J. // Journal of Bone & Joint Surgery, American Volume;Apr2005, Vol. 87-A Issue 4, p699 

    Comments on the introduction of the total hip arthroplasty to the orthopedic community. Information about the benefits of minimally minimally invasive total hip arthroplasty; Differences in the rates of complications of total hip arthroplasty; Methods of invasive total hip arthroplasty.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics