Reconstruction of Femoral Deficiencies

Reconstruction of Femoral Deficiencies

Femoral bone stock is deficient to some degree in most revisions, a condition that may result from (1) osteolysis caused by loosening, wear, or infection; (2) perforation or creation of windows during removal of the previous stem or other implant; (3) stress shielding from an excessively stiff or extensively porous-coated implant; or (4) preexisting osteoporosis and thin femoral cortices. Reconstruction may be complicated further by a femoral deformity or fracture. 

The AAOS Committee on the Hip proposed a system for the classification of femoral deficiencies in total hip arthroplasty. Although the system is most commonly used in reference to revision surgery, it also is applicable to primary arthroplasties. The essential terminology from the acetabular publication has been maintained to promote continuity. Accurate description of deficiencies simplifies preoperative planning. 

Della Valle and Paprosky developed a femoral defectclassification along with guidelines for treatment of each typeof deficiency.

Note: this article comes from CAMPBELL’S OPERATIVE ORTHOPAEDICS by S. Terry Canale James H. Beaty.