Revision of total hip replacement with proximal femur bone defect

Abstract

Background: The revision surgery has been evolving constantly. From polyethylene wear, osteolysis and loosening, to complexities such as pelvic discontinuity, there is a wide range of surgical options for successful reconstruction.
Objective: The aim of the present study was to provide optimal treatment to the increasing number of patients requiring revision surgery with femur bone defect.
Patients and methods: This study included 10 patients with failed primary total hip replacement and have femoral bone defects selected as purposive simple random sample requiring revision of total hip replacement at Zagazig University Hospitals.
Results: All of the patients had femoral defects which were difficult to evaluate accurately preoperatively by radiograph but were properly evaluated during surgery after removal of the loose implant by simple manual traction. Femoral bone defects were classified according to Paprosky classification, they were six patients type 1, three patients type 2 and one patient type 3A. No weight bearing was allowed on the affected limb for 4 weeks. All the patients reached full weight bearing between 7 – 9 weeks after surgery regarding preoperative mean Harris hip score, it was 89. There were no cases of dislocation or deep infection in this series up to the final follow up visit.
Conclusion: The revision surgery has been evolving constantly. However, we do not have complex solution. The optimal surgical approach for revision total hip arthroplasty (THA) varies considerably among different settings.