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Proximal femoral replacements with megaprostheses
Javad Parvizi1, Franklin H Sim
1Rothman Institute, Philadelphia, PA, USA.
Clinical Orthopaedics and Related Research
|April 2, 2004
Summary
Proximal femoral replacement (megaprosthesis) is now reserved for elderly or sedentary patients with severe proximal femur bone loss. Advances in bone grafting have narrowed the indications for these large implants in revision hip surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Revision hip surgery has seen significant advancements.
- Allograft bone (cancellous and cortical) is now widely available.
- Cortical strut grafts are increasingly used to reinforce host bone.
Purpose of the Study:
- To clarify the current role of proximal femoral replacement (megaprosthesis) in revision hip surgery.
- To define the specific indications for megaprosthesis use in complex cases.
Main Methods:
- Review of current reconstructive techniques in revision hip surgery.
- Analysis of indications for megaprosthesis versus bone grafting.
Main Results:
- The use of megaprostheses has become more selective.
- Indications have narrowed due to advances in bone grafting techniques.
- Megaprostheses are reserved for cases with massive proximal femoral bone loss.
Conclusions:
- Proximal femoral replacement is indicated for elderly or sedentary patients with extensive bone loss unsuitable for other reconstructive methods.
- Specific indications include failed total hip arthroplasty, complex nonunions, and hip salvage after resection arthroplasty.