DOI: 10.2106/jbjs.cc.23.00067 ISSN:

Revision Total Hip Arthroplasty Using a Tibial Cone and Impaction Grafting for Severe Femoral Bone Loss

Michael S. Ramos, Pedro Rullan-Oliver, Ignacio Pasqualini, Nicolas S. Piuzzi, Robert M. Molloy
  • Orthopedics and Sports Medicine
  • Surgery
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Case:

An 84-year-old woman presented 6 years after revision total hip arthroplasty (rTHA) with worsening hip pain and a Paprosky classification IIIB femoral defect. rTHA was performed using a proximal femur replacement. Given her osteoporosis and poor bone stock, a tibial cone and impaction grafting (IG) were used for megaprosthesis fixation. At the 33-month follow-up, the patient was pain-free and radiographs demonstrated a well-fixed implant.

Conclusion:

In the setting of massive defects of poor-quality bone, novel use of a tibial cone and IG can be implemented to achieve implant fixation and maximize patient outcomes.

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