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The major proximal femoral defects: megaprosthesis in non oncological patients - A case series
Fabio Zanchini1, Antonio Piscopo1, Valerio Cipolloni1
1Fondazione Policlinico Gemelli IRCSS, Rome, Italy.
Abstract:
We identified 39 patients (23 female and 16 male) underwent hip revisions through mega-prosthesis. The most common causes were periprosthetic fractures, periprosthetic osteolysis and consequences of infected arthroplasty. The average follow-up was 5 years (2.1 to 6.5), and average age was 69 years (47 to 78). At the final follow-up all the implants resulted functional and osteointegrated. The Merle D'Aubignè and Postel hip rating scale was used for the evaluation, better results were observed in periprosthetic fractures. Postoperative complications occurred in eight patients. Thus, megaprosthesis were a reasonable surgical option in the management of major femoral defects.
Insights
Hip revision surgery using megaprosthesis is a viable option for major femoral defects, showing functional and integrated implants after a 5-year follow-up, particularly for periprosthetic fractures.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Hip revision surgery addresses complex cases like periprosthetic fractures, osteolysis, and infected arthroplasty.
- Major femoral defects pose significant challenges in revision hip arthroplasty.
Purpose of the Study:
- To evaluate the efficacy and outcomes of hip revision using megaprosthesis in patients with major femoral defects.
Main Methods:
- Retrospective analysis of 39 patients (23 female, 16 male) undergoing hip revision with megaprosthesis.
- Average follow-up of 5 years (range 2.1-6.5 years); average patient age 69 years (range 47-78 years).
- Assessment using the Merle D'Aubignè and Postel hip rating scale.
Main Results:
- All implants were functional and osteointegrated at final follow-up.
- Better functional outcomes were observed in patients with periprosthetic fractures.
- Eight patients (approximately 20.5%) experienced postoperative complications.
Conclusions:
- Megaprosthesis serve as a reasonable surgical choice for managing major femoral defects during hip revision.
- The procedure demonstrates good implant integration and functionality in the medium term.
