title: Intramedullary and total femur replacement in revision arthroplasty as a last limb-saving option: is there any benefit from the less invasive intramedullary replacement?
abstract: There has been a substantial increase in the number of hip and knee prostheses implanted in recent years, with a consequent increase in the number of revisions required. Total femur replacement (TFR) following destruction of the entire femur, usually after several previous revision operations, is a rare procedure but is the only way of avoiding amputation. Intramedullary femur replacement (IFR) with preservation of the femoral diaphysis is a modification of TFR. Between 1999 and 2010, 27 patients with non-oncological conditions underwent surgery in our department with either IFR (n = 15) or TFR (n = 12) and were included in this study retrospectively. The aim of the study was to assess the indications, complications and outcomes of IFR and TFR in revision cases. The mean follow-up period was 31.3 months (6 to 90). Complications developed in 37% of cases, 33% in the IFR group and 4% in the TFR group. Despite a trend towards a slightly better functional outcome compared with TFR, the indication for intramedullary femur replacement should be established on a very strict basis in view of the procedure's much higher complication rate.
authors: University Hospital Münster, Department of General and Tumor Orthopedics, Albert Schweitzerstrasse 33, Münster 48149, Germany. steffen.hoell@ukmuenster.de
authors: S
authors: S
authors: Hoell
authors: S
authors: S
authors: Butschek
authors: G
authors: G
authors: Gosheger
authors: N
authors: N
authors: Dedy
authors: R
authors: R
authors: Dieckmann
authors: M
authors: M
authors: Henrichs
authors: K
authors: K
authors: Daniilidis
authors: J
authors: J
authors: Hardes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D007720:Knee Prosthesis; D023821:Limb Salvage / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome