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Published on: September 7, 2022
Current concepts in total femoral replacement.
Deepak Ramanathan1, Marcelo Bp Siqueira1, Alison K Klika1
1Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States.
Total femoral replacement (TFR) offers limb salvage as an alternative to amputation, enabling early patient mobilization. This complex procedure requires careful technique and rehabilitation to optimize outcomes and manage potential complications.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Limb Reconstruction
Background:
- Total femoral replacement (TFR) is a critical salvage arthroplasty procedure.
- It serves as an alternative to lower limb amputation for various oncologic and non-oncologic conditions.
- TFR provides immediate fixation, facilitating early patient mobilization.
Purpose of the Study:
- To review the indications, advantages, and complications of total femoral replacement.
- To highlight the importance of surgical technique and rehabilitation for functional outcomes.
- To discuss revision strategies and potential adverse events associated with TFR.
Main Methods:
- Literature review of retrospective case series and case reports on TFR.
- Analysis of available TFR prostheses and their design implications.
- Examination of factors influencing long-term functional outcomes and revision rates.
Main Results:
- TFR is increasingly relevant due to rising revision arthroplasty rates.
- Common reasons for revision TFR include periprosthetic infection and severe femoral bone loss.
- Complications encompass instability, limb length discrepancy, device failure, and wound healing issues.
Conclusions:
- Long-term TFR success depends on surgical technique and rehabilitation.
- Revision TFR may sometimes necessitate hip disarticulation.
- Further research is required to fully understand long-term outcomes and complications of TFR.
