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[Proximal femur replacement in revision arthroplasty]
J Hardes1, T Budny, G Hauschild
1Klinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster. hardes@uni-muenster.de
Zeitschrift Fur Orthopadie Und Unfallchirurgie
|February 26, 2010
Summary
Megaendoprosthesis reconstruction of the proximal femur in revision arthroplasty is a salvage procedure. It offers pain relief and limited walking ability for patients with extensive bone defects, despite a notable complication rate.
Area of Science:
- Orthopedic Surgery
- Arthroplasty Research
- Bone Defect Management
Context:
- Megaendoprostheses, initially for tumor surgery, are increasingly used for extensive bone defects in revision arthroplasty.
- Proximal femur replacements are employed to address complex cases including infection, fracture, and aseptic loosening.
Purpose:
- To evaluate the complication rate and functional outcomes of megaendoprosthesis reconstruction of the proximal femur in a non-oncological patient cohort.
- To assess the efficacy of these reconstructions in revision hip arthroplasty.
Summary:
- A retrospective study of 28 patients (average age 72) undergoing proximal femur replacement for large bone defects.
- Complications included dislocation, aseptic loosening, and infection, necessitating revision surgery in 28.6% of cases.
- Significant pain relief was achieved, and most patients regained mobility, though walking aids were often required.
Impact:
- Proximal femur replacement serves as a crucial salvage procedure for restoring limb function in challenging revision arthroplasty cases.
- The procedure can improve quality of life by enabling limited walking ability and pain reduction in previously immobilized patients.
- Preoperative patient counseling regarding functional limitations and potential complications is essential for managing expectations.
