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Volume 5
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Case Report

A Combined Use of Custom-Made Partial Pelvic Replacement and Proximal Femur Megaprosthesis in the Treatment of Severe Bone Loss after Multiple Total Hip Arthroplasty Revisions

by
Michele Fiore
,
Azzurra Paolucci
,
Renato Zunarelli
,
Marta Bortoli
,
Andrea Montanari
,
Andrea Pace
,
Lorenzo Di Prinzio
,
Stefania Claudia Parisi
,
Roberto De Cristofaro
,
Massimiliano De Paolis
* and
Andrea Sambri
Orthopedics and Traumatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
Prosthesis 2023, 5(4), 1093-1110; https://doi.org/10.3390/prosthesis5040076
Submission received: 26 August 2023 / Revised: 6 October 2023 / Accepted: 18 October 2023 / Published: 24 October 2023
(This article belongs to the Special Issue State of Art in Hip and Knee Replacement)
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Abstract

Hip arthroplasty failures (either septic or aseptic) often require multiple revisions, thus leading to severe bone defects. The most common reconstruction methods do not allow the management of severe defects. For this reason, in recent years, techniques borrowed from surgical oncology have been applied in the field of revision surgery to deal with both acetabular and femoral bone losses. In this article, two cases of severe bone deficiency following multiple hip arthroplasty revisions that were treated with a custom-made hip prosthesis combined with a proximal femur megaprosthesis are presented. Both implants were silver coated. A review of the literature was conducted to analyze similar cases treated with either a custom-made prosthesis or a proximal femur megaprosthesis. At the 2-year follow-up, all prostheses were in site without clinical or radiographic signs of implant loosening. No postoperative complications occurred. At the last follow-up, both patients resumed their daily life activities with an MSTS score of 23 and 21, respectively. The combined approach of a proximal femur megaprosthesis with a custom-made partial pelvic replacement is a solution that allows severe bone deficiency cases to be tackled with good functional results. Additionally, silver coating may help prevent recurrence of infection.
Keywords: severe bone loss; revision hip arthroplasty; custom-made; megaprosthesis; silver severe bone loss; revision hip arthroplasty; custom-made; megaprosthesis; silver

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MDPI and ACS Style

Fiore, M.; Paolucci, A.; Zunarelli, R.; Bortoli, M.; Montanari, A.; Pace, A.; Di Prinzio, L.; Parisi, S.C.; De Cristofaro, R.; De Paolis, M.; et al. A Combined Use of Custom-Made Partial Pelvic Replacement and Proximal Femur Megaprosthesis in the Treatment of Severe Bone Loss after Multiple Total Hip Arthroplasty Revisions. Prosthesis 2023, 5, 1093-1110. https://doi.org/10.3390/prosthesis5040076

AMA Style

Fiore M, Paolucci A, Zunarelli R, Bortoli M, Montanari A, Pace A, Di Prinzio L, Parisi SC, De Cristofaro R, De Paolis M, et al. A Combined Use of Custom-Made Partial Pelvic Replacement and Proximal Femur Megaprosthesis in the Treatment of Severe Bone Loss after Multiple Total Hip Arthroplasty Revisions. Prosthesis. 2023; 5(4):1093-1110. https://doi.org/10.3390/prosthesis5040076

Chicago/Turabian Style

Fiore, Michele, Azzurra Paolucci, Renato Zunarelli, Marta Bortoli, Andrea Montanari, Andrea Pace, Lorenzo Di Prinzio, Stefania Claudia Parisi, Roberto De Cristofaro, Massimiliano De Paolis, and et al. 2023. "A Combined Use of Custom-Made Partial Pelvic Replacement and Proximal Femur Megaprosthesis in the Treatment of Severe Bone Loss after Multiple Total Hip Arthroplasty Revisions" Prosthesis 5, no. 4: 1093-1110. https://doi.org/10.3390/prosthesis5040076

APA Style

Fiore, M., Paolucci, A., Zunarelli, R., Bortoli, M., Montanari, A., Pace, A., Di Prinzio, L., Parisi, S. C., De Cristofaro, R., De Paolis, M., & Sambri, A. (2023). A Combined Use of Custom-Made Partial Pelvic Replacement and Proximal Femur Megaprosthesis in the Treatment of Severe Bone Loss after Multiple Total Hip Arthroplasty Revisions. Prosthesis, 5(4), 1093-1110. https://doi.org/10.3390/prosthesis5040076

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