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General Orthopaedics

Revision Total Hip Arthroplasty in Massive Proximal Femoral Bone Loss With Tumor Endoprosthesis

The International Society for Technology in Arthroplasty (ISTA)



Abstract

Background

Revision THA presents significant challenges for the surgeon when the proximal femur is deficient or mechanically unreliable. The aim of this study is to assess the clinical and functional results of the use of tumor enndoprosthesis to reconstruct the proximal femur when there is massive bone loss.

Patients and Methods

A prospective study was conducted involving 10 cases. The follow up of the cases ranged from 12 months to 30 months with a mean period of an average of 23months. The indications for revision surgery were aseptic loosening in 9 cases and septic loosening in one case Harris hip score was used for pre and postoperative clinical evaluation of the patients

Results

At the latest follow up the Harris Hip scores improved from a preoperative average of 16 (range, 3-47), to a postoperative average of 75.6 (range, 66-94). The complications that we encountered in the study included one case of superficial wound infection, another case developed sciatic nerve palsy postoperatively. No other complications were reported.

Conclusion

Revision hip replacement in proximally compromised femurs presents a significant surgical challenge. When there is massive proximal femoral bone loss proximal fitting revision stems do not achieve adequate fixation hence the use of tumor prosthesis is indicated.


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