97 - Femoral Revision: Classification of Bone Defects and Treatment Options

Abstract

Failure of a primary total hip arthroplasty (THA) typically occurs with varying degrees of femoral bone loss. This bone loss can be the result of osteolysis, mechanical loosening, infection, or stress shielding. Regardless of the underlying cause, femoral bone loss can be extensive, making it difficult to obtain adequate support of the femoral component at the time of revision surgery. As a result, these bone defects can adversely affect the long-term fixation and survival rate of the revised femoral implant. Classifying femoral bone defects is a critical part of the preoperative planning required for a successful revision THA. A classification system that estimates the pattern and degree of bone loss can aid the surgeon in determining the operative plan. The classification system can predict the complexity of the operation, avoid unanticipated intraoperative findings, and provide an algorithmic approach to the reconstruction of the femoral deficiency in revision THA. This is necessary to determine which implants, instruments, and bone graft will need to be available at the time of revision surgery. Because there are various reconstructive options available to revise a failed femoral component, a classification system also allows the uniform comparison of published outcomes of these different reconstructive techniques.