title: An alternative solution to achieve primary stability in cementless revision hip arthroplasty for femur ectasia.
abstract: OBJECTIVE
  Revision total hip arthroplasty is technically demanding, especially when treating a large defective femur. The aim of this study was to evaluate the clinical results of cementless total hip arthroplasty revision in patients with advanced femoral bony defects.
  
  
  METHODS
  By using the canaloplasty technique, which osteotomized the proximal femur to reduce the width of canal, 12 patients were enrolled and underwent revision operation. Patients were evaluated by radiographic examination and Harris hip score before and after the index procedures.
  
  
  RESULTS
  The average length of follow-up was 38.7 months. All the osteotomies united at a mean of 5.3 months. Structural allografts were used on six patients to augment the thinned cortices. A total of 11 femoral components (91%) achieved and maintained stability at the last follow-up. One patient was complicated with early stem subsidence and another with deep infection. Both patients were treated successfully without late sequelae. The mean Harris hip score improved from 37.2 to 75.0 after the operation (p < 0.05).
  
  
  CONCLUSIONS
  The canaloplasty technique could be an alternative solution to help revision surgery in some younger patients with advanced femoral defects.
authors.affiliation: Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taiwan.
authors.forename: En-Rung
authors.initials: ER
authors.lastname: Chiang
authors.forename: Hsiao-Li
authors.initials: HL
authors.lastname: Ma
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Chen
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Su
authors.forename: Tain-Hsiung
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007593:Joint Instability / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation / Q000009:adverse effects*; D012720:Severity of Illness Index; D016896:Treatment Outcome