Outcomes and complications following non-oncologic total femoral replacement. Academic Article uri icon

Overview

abstract

  • 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 years 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.

publication date

  • July 18, 2019

Research

keywords

  • Arthroplasty, Replacement, Hip
  • Femur
  • Postoperative Complications

Identity

Scopus Document Identifier

  • 85070416297

Digital Object Identifier (DOI)

  • 10.1177/1120700019864867

PubMed ID

  • 31317783

Additional Document Info

volume

  • 30

issue

  • 6