The Nasser-Gavvala-Shirodkar-Botchu Classification: A Classification System for Loosening of Endoprosthetic...

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Radiology

Background:

• Femoral endoprosthesis replacement (EPR) is increasingly used in limb reconstruction.
• Loosening is the primary cause of EPR failure.
• A standardized classification for EPR loosening is lacking.

Purpose of the Study:

• To introduce a novel, reproducible classification system for femoral endoprosthesis replacement (EPR) loosening.
• To categorize loosening based on anatomical location relative to the prosthesis.

Main Methods:

• Retrospective review of radiographs and CT scans from 28 adult patients undergoing revision EPR for loosening.
• Development of a 6-grade classification system based on loosening location and associated complications.
• Analysis of patient demographics and time to loosening diagnosis.

Main Results:

• Grade 3 loosening (around the prosthesis shaft) was the most frequent pattern, observed in 57.1% of cases.
• The average time from initial surgery to diagnosis of loosening was 10.1 years.
• The majority of patients were male (61%) with a mean age of 50.6 years.

Conclusions:

• The proposed classification system offers a simple and reproducible method for describing EPR loosening.
• This system has the potential to guide revision surgical strategies and improve future EPR designs.
• Standardized evaluation of loosening can aid in developing national guidelines for managing this complication.