Current concepts in total femoral replacement.

Autor:	Ramanathan D; Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States., Siqueira MB; Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States., Klika AK; Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States., Higuera CA; Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States., Barsoum WK; Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States., Joyce MJ; Deepak Ramanathan, Marcelo BP Siqueira, Alison K Klika, Carlos A Higuera, Wael K Barsoum, Michael J Joyce, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, United States.
Jazyk:	angličtina
Zdroj:	World journal of orthopedics [World J Orthop] 2015 Dec 18; Vol. 6 (11), pp. 919-26. Date of Electronic Publication: 2015 Dec 18 (Print Publication: 2015).
DOI:	10.5312/wjo.v6.i11.919
Abstrakt:	Total femoral replacement (TFR) is a salvage arthroplasty procedure used as an alternative to lower limb amputation. Since its initial description in the mid-20(th) century, this procedure has been used in a variety of oncologic and non-oncologic indications. The most compelling advantage of TFR is the achievement of immediate fixation which permits early mobilization. It is anticipated that TFR will be increasingly performed as the rate of revision arthroplasty rises worldwide. The existing literature is mainly composed of a rather heterogeneous mix of retrospective case series and a wide assortment of case reports. Numerous TFR prostheses are currently available and the surgeon must understand the unique implications of each implant design. Long-term functional outcomes are dependent on adherence to proper technique and an appropriate physical therapy program for postoperative rehabilitation. Revision TFR is mainly performed for periprosthetic infection and the severe femoral bone loss associated with aseptic revisions. Depending on the likelihood of attaining infection clearance, it may sometimes be advisable to proceed directly to hip disarticulation without attempting salvage of the TFR. Other reported complications of TFR include hip joint instability, limb length discrepancy, device failure, component loosening, patellar maltracking and delayed wound healing. Further research is needed to better characterize the long-term functional outcomes and complications associated with this complex procedure.
Databáze:	MEDLINE
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