title: Custom-made segmental femoral replacement prosthesis in revision total hip arthroplasty.
abstract: Patients who present with failed total hip arthroplasty and significant proximal femoral bone loss pose a challenging reconstructive problem. When the integrity of the host proximal femur can be salvaged with cortical strut grafts, conventional long-stem femoral components can be used. If there is massive proximal femoral bone loss, hip salvage can be accomplished with a proximal femoral replacement prosthesis or an allograft-prosthesis composite. Although our early results with a proximal femoral replacement prosthesis were good, long-term results reveal a high rate of dislocation and acetabular component loosening, with an overall survivorship of 73% at 11 years. We have, therefore, limited the use of a proximal femoral replacement prosthesis to the elderly and inactive patient. We are encouraged by the preliminary results of total hip arthroplasty with a second-generation, modular, porous-coated, proximal femoral replacement prosthesis. Longer follow-up is required to determine whether these design modifications improve the results of this type of reconstructive procedure in revision total hip arthroplasty.
authors.affiliation: Department of Orthopedics, Mayo Clinc, Rochester, Minnesota.
authors.forename: A L
authors.initials: AL
authors.lastname: Malkani
authors.forename: F H
authors.initials: FH
authors.lastname: Sim
authors.forename: E Y
authors.initials: EY
authors.lastname: Chao
mesh_terms: D000328:Adult; D000368:Aged; D001843:Bone Cements; D001862:Bone Resorption / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D001843:Bone Cements