Proximal femur reconstruction with a cemented allograft-prosthesis composite and a new type of plate in young patients: Surgical technique

Abstract

Purpose and aim: To describe an alternative surgical technique for treating proximal femur tumor lesions in young patients. Background: Reconstruction of segmental defects is a major challenge for orthopedic oncologic surgeons. Bone reconstruction of these defects aims to restore bone length and function. Currently, the most widely used methods for reconstruction are mega-prosthesis or cemented allograft-prosthesis composite (APC). Technique: The proposed approach consists of implanting a cemented allograft-short prosthesis composite and synthesis with a new type of plate, Depuy Synthes® VA-LCP PPFx proximal femur Hook Plate 3.5/4.5/5.0 mm. Conclusions: This technique involves meticulous planning of implants and selection of the synthesis device with precise measurements on X-rays and intra-operatively. It allows the surgeon to standardize the procedure providing good synthesis stability and possibly subsequent proper osseointegration of the allograft with the native bone. Moreover, using a prosthesis with a short stem prevents affecting the bone reserve of the healthy femur and may obviate the risk of excessive bone stock loss associated with this surgical procedure. Clinical significance: A relatively straightforward surgical technique, stable synthesis, and adequate osseointegration feasibility between allograft and native bone.

Keywords

• Bone graft
• Allograft
• APC
• Proximal femur reconstruction
• Surgical technique
• Plate