November 13, 2014
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TFA a potential alternative to amputation for patients with massive femoral bone deficiency

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Although total femoral arthroplasty performed poorly among patients with infection and instability, the procedure was a viable alternative to amputation in patients with massive femoral bone deficiency, according to study results.

Researchers retrospectively reviewed 20 patients who underwent non-oncologic total femoral arthroplasties (TFAs) and a minimum of 2 years follow-up.

The researchers found a 25% incidence of new non-oncologic TFA infection and a 35% overall infection rate.

After non-oncologic TFA, the incidence of primary hip instability was 10%, and overall instability was 25%. A statistically significant 35-point increase from preoperative to postoperative Harris Hip Scores was observed, according to the researchers.

Through individual evaluation of clinical complaints, the researchers found that only 10% of patients continued to complain of pain postoperatively.

Thirty percent of patients were non-ambulatory and confined to a wheelchair at final follow-up, and 70% were ambulatory after non-oncologic TFA, with seven requiring a walker, four requiring use of a cane and three with no ambulatory gait aid.

Revision for any failure mode was performed in 30% of the patients studied. Hip instability and infection were the most common modes of failure, according to the researchers.

Disclosure: See the study for a full list of all authors’ relevant financial disclosures.