Long stem femoral components for total hip replacement

Certain special problems in reconstruction of the arthritis hip in the adult require the use of a femoral component that has a long stem. A long stem component is essential if a major defect exists in the cortex of the proximal portion of the femur. Examples of such defects are windows cut in the femur to remove cement or to remove a broken femoral stem. Another example is the hole made by penetration of a femoral stem through the cortex. Standard long stem components are used for these cases. A new device in the long stem family, called the calcar replacement long stem component, is designed to restore leg length in those cases in which the femoral calcar has been removed or resorbed. It is also being used in certain cases of heterotopic ossification. In certain cases of primary or secondary malignant disease the entire proximal portion of the femur is excised and the proximal femoral replacement long stem component is inserted. The use of these long stem femoral components is illustrated and the limitations and pitfalls are discussed.