title: Massive bone loss: allograft-prosthetic composites and beyond.
abstract: Revision total hip arthroplasty (THA) is projected   to increase by 137% from the years 2005 to 2030. Reconstruction of   the femur with massive bone loss can be a formidable undertaking.   The goals of revision surgery are to create a stable construct,   preserve bone and soft tissues, augment deficient host bone, improve   function, provide a foundation for future surgery, and create a   biomechanically restored hip. Options for treatment of the compromised femur   include: resection arthroplasty, allograft prosthetic composite   (APC), proximal femoral replacement, cementless fixation with a   modular tapered fluted stem, and impaction grafting. The purpose   of this article is to review the treatment options along with their   associated outcomes in the more severe femoral defects (Paprosky types   IIIb and IV) in revision THA.
authors.affiliation: Rush University Medical Center, 1620 West Harrison Avenue, Chicago, Illinois 60612, USA. robmayle@gmail.com
authors.forename: R E
authors.initials: RE
authors.lastname: Mayle
authors.forename: W G
authors.initials: WG
authors.lastname: Paprosky
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D016025:Bone Transplantation; D005269:Femur / Q000293:injuries / Q000473:pathology* / Q000601:surgery / Q000637:transplantation; D006622:Hip Prosthesis; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome