Femoral Fixation Research Paper

MODALITIES OF FEMORAL FIXATION The goals of femoral component revision are to achieve implant stability while restoring hip biomechanics. Multiple fixation options exist for proximal femoral reconstruction including cemented components with or without associated bone restoration techniques, uncemented components, and patient specific implants such as modular or custom components. As previously mentioned, the Paprosky classification is most commonly used to describe proximal femur deficiency [31-33, 52]. This classification scheme allows effective communication between surgeons and is a good predictor of surgical complexity. Intra-operative bone deficits and reconstruction options can be predicted based upon pre-operative classification of the proximal femoral deficiency. Clinical success may be achieved with any of the multitude of

While disadvantages such as early loosening, instability, limb length discrepancy and associated sciatic nerve palsy, and decimation of remaining proximal femoral bone stock cannot be ignored, these implants can be inserted quickly and provide immediate stability and predictable result. A recent study reviewing proximal femoral arthroplasty in revision THA for severe bone loss [74] demonstrated stable prostheses and independent ambulation in all patients at a mean follow-up of 4.8 years. Malkani et al. [68] examined long term results of proximal femoral arthroplasty for non-neoplastic conditions. At 12 years, overall survivorship was 64% and almost half of the patients had substantial ambulatory dysfunction (i.e. severe limp or inability to walk) post-operatively. However, Harris Hip scores increased from 46 to 76 points at most recent follow-up. While we cannot discount the notable disadvantages associated with proximal femoral replacement, further study is certainly warranted to determine its role in revision