HIP International | 2019

Outcomes and complications following non-oncologic total femoral replacement



Background: Non-oncologic total femoral replacement (TFR) is utilised as a limb-salvage option in the setting of massive bone loss during revision total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, complication rates, including infection and reoperation, remain a concern. Methods: In this study, 16 consecutive TFRs from a single institution with an average clinical follow-up of 4\u2009years were retrospectively reviewed. Indications for TFR, previous surgeries, implants used, complications, reoperations, and ambulatory status at final follow-up were recorded. Results: The reoperation rate was 50%, and those patients averaged 2 additional surgeries after TFR. The most common reason for reoperation was infection with a 33% incidence of a new periprosthetic infection and an overall infection rate of 44% (7/16). 6/7 were managed with irrigation and debridement and implant retention. Dual-mobility and constrained acetabular liners were used consistently, and no patient experienced a subsequent dislocation. At final follow-up, 81% were ambulatory but only 2 patients (13%) could walk without an assistive device. No patient required amputation. Conclusions: While TFR achieved limb salvage in all patients with fair clinical outcomes, patients were at high risk for new or persistent infection and reoperation. Dual-mobility and constrained acetabular liners were effective in preventing dislocation is this cohort.

Volume 30
Pages 725 - 730
DOI 10.1177/1120700019864867
Language English
Journal HIP International

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