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Updated: May 28, 2026
09:01
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Optimizing Outcomes in Total Femur Replacement: Complications, Management Strategies, and Lessons Learned
Zofia Wrześniak1, Bartłomiej Wilk1, Łukasz Pulik2
1Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland.
Medicina (Kaunas, Lithuania)
|May 27, 2026
Summary
Total femoral replacement (TFR) is complex and has high complication rates, particularly infection and wound issues. Early intervention, allergy screening, and specific implant choices can mitigate risks and improve outcomes.
Area of Science:
- Orthopedic Surgery
- Oncology
- Reconstructive Surgery
Background:
- Total femoral replacement (TFR) initially for malignant tumors.
- Indications expanded to failed endoprosthetic replacements and severe trauma.
- TFR is a complex procedure with significant complication risks.
Purpose of the Study:
- Analyze complication management in TFR.
- Propose strategies to mitigate TFR-associated risks.
Main Methods:
- Retrospective study across two independent hospitals.
- Inclusion of patients undergoing TFR for oncological, revision, or trauma indications.
Main Results:
- 19 patients included: 8 oncological, 11 revision/trauma.
- 53% experienced complications: infection (21%), wound healing (26%), dislocation (21%), implant failure (11%), metal allergy (5%).
- 32% required revision surgery; no amputations.
Conclusions:
- TFR has a high complication rate, primarily infection and wound healing issues.
- Effective management includes early intervention, pre-operative allergy screening, dual mobility bearings, intraoperative antibiotics, and VAC therapy.
- Implementing these strategies can improve patient outcomes and reduce complication burden.
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