title: Proximal femoral arthroplasty in patients undergoing revision hip arthroplasty.
abstract: Bone loss represents one of the greatest challenges in revision joint surgery. A retrospective review was conducted of both radiographic and clinical outcomes of eleven patients who underwent revision arthroplasty using a long extensively porous coated cylindrical femoral component. All patients' femurs presented with severe proximal femoral bone loss (Paprosky class IIIB and IV). With a mean follow-up of 8 years (2 to 14) we report no femoral revisions and one acetabular revision to a constrained cup secondary to instability. All patients were clinically and radiographically stable. We did not observe any issue with proximal stress shielding or component loosening. The article reports that in patients with severe proximal femoral bone loss, extensively porous-coated non-modular stems are a viable option offering stable and predictable outcomes.
authors.affiliation: Bluewater health, Sarnia, Ontario, Canada.
authors.forename: Gerard M J
authors.initials: GM
authors.lastname: March
authors.affiliation: Department of surgery, Division of Orthopaedic Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Niloofar
authors.initials: N
authors.lastname: Dehghan
authors.affiliation: Division of Orthopaedic Surgery, Adult Reconstructive Service, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Luca
authors.initials: L
authors.lastname: Gala
authors.affiliation: Department of Orthopaedic Surgery, Adult Reconstruction Service, Mayo Clinic Arizona, Phoenix, AZ.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Spangehl
authors.affiliation: Division of Orthopaedic Surgery, Adult Reconstructive Service, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Kim
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001862:Bone Resorption / Q000601:surgery*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies
keywords: distal fixation; extensively porous-coated non-modular stems; femoral bone loss; osteointegration; revision hip arthroplasty