[Total hip prosthesis in bone loss of the femur]

Severe bone deficiency in total hip arthroplasty (THA) represents a serious problem, and there is an increasing demand for reconstructive measurements even on the femoral side to salvage these hips. The different therapeutical concepts are reviewed. Mechanical stability has proved to be of the utmost importance for successful results; fixation of the prosthesis by acrylic cement both in the graft and in the host femur seems to be superior to cementless fixation in most cases. The Wagner cementless self-locking revision stem has the advantage of facilitating regeneration in the deficient proximal femur without allografts and their disadvantages.