title: Management of severe femoral bone loss in revision total hip arthroplasty.
abstract: Femoral bone loss is a complex problem in revision total hip arthroplasty. The Paprosky classification is used when determining the degree and location of bone loss. Meticulous operative planning is essential where severe bone loss is a concern. One must correctly identify the bone loss pattern, safely remove the existing components, and proceed with the proper reconstruction technique based on the pattern of bone loss. This article discusses the etiology and classification of bone loss, clinical and radiographic evaluation, components of effective preoperative planning, and clinical results of various treatment options with a focus on more severe bone loss patterns.
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania, 800 Spruce Street, 8th Floor Preston Building, Philadelphia, PA 19107, USA.
authors.forename: Neil P
authors.initials: NP
authors.lastname: Sheth
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA 19104, USA. Electronic address: christopher.melnic@uphs.upenn.edu.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Melnic
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania, 3737 Market Street, 6th Floor, Philadelphia, PA 19104, USA.
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Rozell
authors.affiliation: Department of Orthopaedic Surgery, Midwest Orthopaedics, Rush University, 1655 West Harrison Street, Chicago, IL 60612, USA.
authors.forename: Wayne G
authors.initials: WG
authors.lastname: Paprosky
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000601:surgery*; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications / Q000517:prevention & control; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Preoperative planning; Reconstruction; Revision total hip arthroplasty; Severe femoral bone loss