McLean AL. Injury. 2012. doi:10.1016/j.injury.2012.03.024
Good clinical results may be achieved through endoprosthetic replacement of the femur in patients with periprosthetic fracture and bone loss, according to this study from researchers in the United Kingdom.
According to the study abstract, the authors operated on 20 patients with a mean age of 72 years, replacing the total femur or proximal femur (5 patients and 15 patients, respectively) to treat periprosthetic femoral fracture with bone loss. The mean time between initial primary total hip replacement and endoprosthetic replacement was 12.5 years, and mean follow-up was 48 months.
Clinical outcomes were assessed through the Toronto Extremity Salvage score (mean: 68), SF-36 (mean Physical Component Score: 53) and Mental Component Score (mean: 51). The authors reported no prostheses were found to be radiologically loose. The authors noted six major complications, including three postoperative dislocations, two persistent deep infections and one fracture of the femur distal to the femoral stem of a proximal femoral replacement.
“Endoprosthetic replacement of the femur is a reasonable salvage option for patients with periprosthetic fracture and bone loss, with good clinical results,” they wrote wrote. “It allows immediate weight bearing and does not rely on bony union for success.”