Massive Femoral Bone Loss: Solutions of Last Resort

Despite remarkable advances in the field of revision surgery during the last decades, the reconstruction in patients with massive femoral bone loss is still challenging. Proximal femoral replacement (megaprosthesis) and the use of an allograft-prosthesis composite are 2 valuable options for managing severe proximal femoral bone loss conditions. Although an allograft-prosthesis composite has several advantages, such as a potential restoration of proximal femoral bone mass and providing a site for soft-tissue attachment, a proximal femoral replacement has the benefit of being more readily available, technically less demanding, and more expeditious to implant than allograft-prosthesis composite. The outcome of megaprosthesis in non-neoplastic condition is dependent on several different issues, including patient selection, appropriate preoperative planning and templating, proper surgical techniques, and good postoperative care. We believe that proximal femoral replacement is a viable option for reconstruction of elderly and sedentary patients with severe femoral bone deficiency.