Advertisement

Total Femoral Replacement (TFR)

  • Eustathios Kenanidis
  • Eleftherios Tsiridis
  • Adolph V. LombardiJr
  • Andrew B. Richardson
  • Michael Müller
Chapter

Abstract

TFR is an established treatment method in oncologic reconstruction [1]. Apart from this TFR has also been used in the non-oncologic setting as a salvage option for the management of extensive femoral bone loss in revision THA [2]. When TFR is performed in specialized centers, TFR can restore femoral integrity, control pain, and allow patients to resume ambulation, albeit at a compromised level; this is considered to be superior to the alternative, which is amputation or hip disarticulation. Careful patient selection, excellent surgical technique, a comprehensive rehabilitation program, and the prompt management of postoperative complications are essential to ensure optimal long-term outcomes in this challenging patient population [3].

References

  1. 1.
    Sewell MD, Spiegelberg BG, Hanna SA, Aston WJ, Bartlett W, Blunn GW, David LA, Cannon SR, Briggs TW. Total femoral endoprosthetic replacement following excision of bone tumors. J Bone Joint Surg Br. 2009;91:1513–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Berend KR, Lombardi AV, Mallory TH, Adams JB, Dodds KL. Total femoral arthroplasty for salvage of end-stage prosthetic disease. Clin Orthop Relat Res. 2004;427:162–70.CrossRefGoogle Scholar
  3. 3.
    Ramanathan D, Siqueira MBP, Klika AK, Higuera CA, Barsoum WK, Joyce MJ. Current concepts in total femoral replacement. World J Orthop. 2015;6(11):919–26.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Fountain JR, Dalby-Ball J, Carroll FA, Stockley I. The use of total femoral arthroplasty as a limb salvage procedure: the Sheffield experience. J Arthroplasty. 2007;22:663–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Sherman SL, Cunneen KP, Walcott-Sapp S, Brause B, Westrich GH. Custom total femur spacer and second-stage total femur arthroplasty as a novel approach to infection and periprosthetic fracture. J Arthroplasty. 2008;23:781–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Clement ND, MacDonald D, Ahmed I, Patton JT, Howie CR. Total femoral replacement for salvage of periprosthetic fractures. Orthopedics. 2014;37:e789–95.CrossRefPubMedGoogle Scholar
  7. 7.
    Lombardi AV, Berend KR. The shattered femur: radical solution options. J Arthroplasty. 2006;21:107–11.CrossRefPubMedGoogle Scholar
  8. 8.
    Ashworth A, Klein AA. Cell salvage as part of a blood conservation strategy in anesthesia. Br J Anaesth. 2010;105:401–16.CrossRefPubMedGoogle Scholar
  9. 9.
    Kaibori M, Matsui K, Ishizaki M, Sakaguchi T, Matsushima H, Matsui Y, Kwon AH. A prospective randomized controlled trial of hemostasis with a bipolar sealer during hepatic transection for liver resection. Surgery. 2013;154:1046–52.CrossRefPubMedGoogle Scholar
  10. 10.
    Nerubay J, Katznelson A, Tichler T, Rubinstein Z, Morag B, Bubis JJ. Total femoral replacement. Clin Orthop Relat Res. 1988;229:143–8.Google Scholar
  11. 11.
    Amanatullah DF, Trousdale RT, Hanssen AD, Lewallen DG, Taunton MJ. Non-oncologic total femoral arthroplasty: retrospective review. J Arthroplasty. 2014;29:2013–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Hwang JS, Beebe KS, Patterson FR, Benevenia J. Infected total femoral replacements: evaluation of limb loss risk factors. Orthopedics. 2011;34:e736–40.PubMedGoogle Scholar
  13. 13.
    Friesecke C, Plutat J, Block A. Revision arthroplasty with use of a total femur prosthesis. J Bone Joint Surg Am. 2005;87:2693–701.CrossRefPubMedGoogle Scholar
  14. 14.
    Mankin HJ, Hornicek FJ, Harris M. Total femur replacement procedures in tumor treatment. Clin Orthop Relat Res. 2005;438:60–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Steinbrink K, Engelbrecht E, Fenelon GC. The total femoral prosthesis. A preliminary report. J Bone Joint Surg Br. 1982;64:305–12.CrossRefPubMedGoogle Scholar
  16. 16.
    Ward WG, Dorey F, Eckardt JJ. Total femoral endoprosthetic reconstruction. Clin Orthop Relat Res. 1995;316:195–2.Google Scholar
  17. 17.
    McLean AL, Patton JT, Moran M. Femoral replacement for salvage of periprosthetic fracture around a total hip replacement. Injury. 2012;43(7):1166–9. doi: 10.1016/j.injury.2012.03.024. Epub 2012 Apr 27CrossRefPubMedGoogle Scholar
  18. 18.
    Sheth NP, Melnic CM, Rozell JC, Paprosky WG. Management of severe femoral bone loss in revision total hip arthroplasty. Orthop Clin North Am. 2015;46(3):329–42, ix. doi: 10.1016/j.ocl.2015.02.002. Epub 2015 Apr 11CrossRefPubMedGoogle Scholar
  19. 19.
    Bianchi L, Galante C, Zagra L. The management of femoral bone stock in THA revision: indications and techniques. Hip Int. 2014;24(Suppl 10):S37–43. doi: 10.5301/hipint.5000174.CrossRefPubMedGoogle Scholar
  20. 20.
    Mayle RE Jr, Paprosky WG. Massive bone loss: allograft-prosthetic composites and beyond. J Bone Joint Surg Br. 2012;94(11 Suppl A):61–4. doi: 10.1302/0301-620X.94B11.30791.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eustathios Kenanidis
    • 1
  • Eleftherios Tsiridis
    • 2
    • 3
  • Adolph V. LombardiJr
    • 4
    • 5
    • 6
  • Andrew B. Richardson
    • 4
  • Michael Müller
    • 7
  1. 1.Academic Orthopaedic UnitAristotle University Medical SchoolThessalonikiGreece
  2. 2.Papageorgiou General HospitalPavlos MelasGreece
  3. 3.Aristotle University Medical SchoolThessalonikiGreece
  4. 4.Joint Implant Surgeons, Inc.New AlbanyUSA
  5. 5.Department of OrthopaedicsThe Ohio State University Wexner Medical CenterColumbusUSA
  6. 6.Mount Carmel Health SystemColumbusUSA
  7. 7.Department of Traumatology and Reconstructive SurgeryCharité Universitätsmedizin BerlinBerlinGermany

Personalised recommendations