title: Custom-made cement-linked mega prostheses: a salvage solution for complex periprosthetic femoral fractures.
abstract: Periprosthetic femoral fractures with long stem implants, poor bone stock and loosening pose a considerable surgical challenge. We describe a reconstruction technique using a custom-made mega-prosthesis, cement-linked to the femoral stem of a well-fixed existing implant. Clinical and radiological outcomes were assessed at our tertiary referral centre. There were 15 patients with a periprosthetic femoral fracture: 5 proximal and 10 distal femoral arthroplasties linked to existing femoral stems. The survival rate was 93.3% at a mean follow-up of 5.3 years (0.5-19.3) with 1 revision. We present a salvage technique with good intermediate-term outcomes for highly selected patients with complex periprosthetic femoral fractures, as another option to conventional fixation methods. Specifically, it allows immediate weight bearing and avoids some of the morbidity of total femoral arthroplasty or amputation.
authors: Joint Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, London, UK.
authors: Nirav K
authors: NK
authors: Patel
authors: Paul
authors: P
authors: Whittingham-Jones
authors: William J
authors: WJ
authors: Aston
authors: Robert C
authors: RC
authors: Pollock
authors: John A
authors: JA
authors: Skinner
authors: Timothy W R
authors: TW
authors: Briggs
authors: Jonathan
authors: J
authors: Miles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D001843:Bone Cements; D002484:Cementation; D005260:Female; D005269:Femur / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000601:surgery*; D011474:Prosthesis Design; D012086:Reoperation
chemical_list: D001843:Bone Cements
keywords: cement-linked; custom-made; limb salvage; mega prosthesis; periprosthetic femoral fracture