Case reportCustom-made lateral femoral hemiarthroplasty for traumatic bone loss: A case report

•Type-C distal femoral fractures with massive comminution present a major surgical challenge.•We present a patient with AO type 33 C3 fracture who underwent hemiarthroplasty with a custom-made prosthesis.•The surgery resulted in direct stability, and preservation of the bone stock and biomechanics of the knee.

We report the case of a 32-year-old male patient involved in a road traffic accident in which he sustained a grade II open supra- and intercondylar fracture of the left distal femur with substantial bone loss of the lateral femoral condyle and trochlea (AO classification type 33 C3). Normal knee function was no longer possible, as the patella was trapped within the bony defect. Existing reconstructive options such as unicondylar osteoarticular allograft, arthrodesis, and arthroplasty were considered. However, as all these techniques present significant disadvantages, particularly in young and active patients, a custom-made lateral hemiarthroplasty was designed and implanted as an alternative treatment. Follow-up at 24 months revealed an excellent, pain-free level of function and radiographs showed no signs of implant loosening or migration. This technique offers the most anatomical means of reconstruction with maximal preservation of the bone stock, thereby better facilitating any revisions that may be necessary in the future. This is an experimental technique reserved for rare indications, and currently has no long-term follow-up results associated with its use. Additional research is therefore needed before widespread adoption of this technique can take place.