Single-Institution Experience With Nononcologic Total Femoral Replacement
Background: Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcol...
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Elsevier
2025-02-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124002929 |
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| author | Ryan Ouillette, MD Kevin Chen, BA Matthew Dipane, BA Alexander Christ, MD Edward McPherson, MD Alexandra Stavrakis, MD |
| author_facet | Ryan Ouillette, MD Kevin Chen, BA Matthew Dipane, BA Alexander Christ, MD Edward McPherson, MD Alexandra Stavrakis, MD |
| author_sort | Ryan Ouillette, MD |
| collection | DOAJ |
| description | Background: Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcologic TFR in one of the largest single-center modern series. Methods: A retrospective analysis was conducted on 23 nononcologic TFR procedures performed on 22 patients between 2012 and 2021. Primary outcomes included TFR revision rate and indication for revision, while secondary outcomes included overall reoperation rate, complications, patient ambulatory status, and assistive device requirements. Results: The average age at time of TFR was 65.7 years, with periprosthetic fracture (65.2%) and periprosthetic joint infection (34.8%) as predominant indications. More than half of patients (52.2%) required TFR revision, primarily due to periprosthetic joint infection (75.0%). Despite a high complication profile, only 1 patient underwent limb amputation and there was only 1 mortality during the study period. Overall, 63.6% of patients were ambulating (assisted or unassisted) at final follow-up. Conclusions: Nononcologic TFR remains a viable limb-salvage option for patients undergoing revision arthroplasty with extensive bone loss. Despite a notable revision rate and infection risk, the majority of patients maintain or regain ambulatory function, emphasizing the procedure’s role in preserving limb function. Clinicians should weigh potential complications when considering TFR, emphasizing patient counseling and risk mitigation strategies. |
| format | Article |
| id | doaj-art-fe5a479eddb9440a92784c303564aa5b |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-fe5a479eddb9440a92784c303564aa5b2025-02-10T04:34:31ZengElsevierArthroplasty Today2352-34412025-02-0131101607Single-Institution Experience With Nononcologic Total Femoral ReplacementRyan Ouillette, MD0Kevin Chen, BA1Matthew Dipane, BA2Alexander Christ, MD3Edward McPherson, MD4Alexandra Stavrakis, MD5Corresponding author. University of California, Los Angeles, 1225 15th St Suite 2100, Santa Monica, CA, 90404, USA. Tel.: +1 951 303 5969.; Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, CA, USADepartment of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, CA, USADepartment of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, CA, USADepartment of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, CA, USADepartment of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, CA, USADepartment of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, CA, USABackground: Revision hip and knee arthroplasty volume continues to rise, and total femur replacement (TFR) remains a key salvage option in patients with extensive bone loss. Prior research has demonstrated mixed results of this procedure, and this study aimed to characterize the outcomes of nononcologic TFR in one of the largest single-center modern series. Methods: A retrospective analysis was conducted on 23 nononcologic TFR procedures performed on 22 patients between 2012 and 2021. Primary outcomes included TFR revision rate and indication for revision, while secondary outcomes included overall reoperation rate, complications, patient ambulatory status, and assistive device requirements. Results: The average age at time of TFR was 65.7 years, with periprosthetic fracture (65.2%) and periprosthetic joint infection (34.8%) as predominant indications. More than half of patients (52.2%) required TFR revision, primarily due to periprosthetic joint infection (75.0%). Despite a high complication profile, only 1 patient underwent limb amputation and there was only 1 mortality during the study period. Overall, 63.6% of patients were ambulating (assisted or unassisted) at final follow-up. Conclusions: Nononcologic TFR remains a viable limb-salvage option for patients undergoing revision arthroplasty with extensive bone loss. Despite a notable revision rate and infection risk, the majority of patients maintain or regain ambulatory function, emphasizing the procedure’s role in preserving limb function. Clinicians should weigh potential complications when considering TFR, emphasizing patient counseling and risk mitigation strategies.http://www.sciencedirect.com/science/article/pii/S2352344124002929Total femur replacementRevision arthroplastyProsthetic joint infectionPeriprosthetic fracture |
| spellingShingle | Ryan Ouillette, MD Kevin Chen, BA Matthew Dipane, BA Alexander Christ, MD Edward McPherson, MD Alexandra Stavrakis, MD Single-Institution Experience With Nononcologic Total Femoral Replacement Arthroplasty Today Total femur replacement Revision arthroplasty Prosthetic joint infection Periprosthetic fracture |
| title | Single-Institution Experience With Nononcologic Total Femoral Replacement |
| title_full | Single-Institution Experience With Nononcologic Total Femoral Replacement |
| title_fullStr | Single-Institution Experience With Nononcologic Total Femoral Replacement |
| title_full_unstemmed | Single-Institution Experience With Nononcologic Total Femoral Replacement |
| title_short | Single-Institution Experience With Nononcologic Total Femoral Replacement |
| title_sort | single institution experience with nononcologic total femoral replacement |
| topic | Total femur replacement Revision arthroplasty Prosthetic joint infection Periprosthetic fracture |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124002929 |
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