Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

Abstract Background Several studies have evaluated the survivorship and clinical outcomes of proximal femoral replacement (PFR) in complex primary and revision total hip arthroplasty with severe proximal femoral bone loss; however, there remains no consensus on the overall performance of this implan...

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Autores principales:	Fabio Mancino, Vincenzo Di Matteo, Fabrizio Mocini, Giorgio Cacciola, Giuseppe Malerba, Carlo Perisano, Ivan De Martino
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Proximal femoral replacement Proximal femoral arthroplasty Femoral revision Femoral bone loss Bone defect Femoral reconstruction Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/c07808b2455647e4920f1d640874e0c7
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spelling	oai:doaj.org-article:c07808b2455647e4920f1d640874e0c72021-11-14T12:28:13ZSurvivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review10.1186/s12891-021-04711-w1471-2474https://doaj.org/article/c07808b2455647e4920f1d640874e0c72021-11-01T00:00:00Zhttps://doi.org/10.1186/s12891-021-04711-whttps://doaj.org/toc/1471-2474Abstract Background Several studies have evaluated the survivorship and clinical outcomes of proximal femoral replacement (PFR) in complex primary and revision total hip arthroplasty with severe proximal femoral bone loss; however, there remains no consensus on the overall performance of this implant. We therefore performed a systematic review of the literature in order to examine survivorship and complication rates of PFR usage. Methods A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was conducted for English articles using various combinations of keywords. Results In all, 18 articles met the inclusion criteria. A total of 578 PFR were implanted. The all-cause reoperation-free survivorship was 76.6%. The overall complication rate was 27.2%. Dislocation was the most common complication observed and the most frequent reason for reoperation with an incidence of 12.8 and 7.6%, respectively. Infection after PFR had an incidence of 7.6% and a reoperation rate of 6.4%. The reoperation rate for aseptic loosening of the implant was 5.9%. Overall, patients had improved outcomes as documented by postoperative hip scores. Conclusion PFR usage have a relatively high complication rate, however, it remains an efficacious treatment option in elderly patients with osteoporotic bone affected by severe proximal femoral bone loss. Modular designs have shown reduced dislocations rate and higher survivorship free from dislocation. However, PFR should only be used as salvage procedure when no other reconstruction options are available.Fabio MancinoVincenzo Di MatteoFabrizio MociniGiorgio CacciolaGiuseppe MalerbaCarlo PerisanoIvan De MartinoBMCarticleProximal femoral replacementProximal femoral arthroplastyFemoral revisionFemoral bone lossBone defectFemoral reconstructionDiseases of the musculoskeletal systemRC925-935ENBMC Musculoskeletal Disorders, Vol 22, Iss S2, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Proximal femoral replacement Proximal femoral arthroplasty Femoral revision Femoral bone loss Bone defect Femoral reconstruction Diseases of the musculoskeletal system RC925-935
spellingShingle	Proximal femoral replacement Proximal femoral arthroplasty Femoral revision Femoral bone loss Bone defect Femoral reconstruction Diseases of the musculoskeletal system RC925-935 Fabio Mancino Vincenzo Di Matteo Fabrizio Mocini Giorgio Cacciola Giuseppe Malerba Carlo Perisano Ivan De Martino Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
description	Abstract Background Several studies have evaluated the survivorship and clinical outcomes of proximal femoral replacement (PFR) in complex primary and revision total hip arthroplasty with severe proximal femoral bone loss; however, there remains no consensus on the overall performance of this implant. We therefore performed a systematic review of the literature in order to examine survivorship and complication rates of PFR usage. Methods A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was conducted for English articles using various combinations of keywords. Results In all, 18 articles met the inclusion criteria. A total of 578 PFR were implanted. The all-cause reoperation-free survivorship was 76.6%. The overall complication rate was 27.2%. Dislocation was the most common complication observed and the most frequent reason for reoperation with an incidence of 12.8 and 7.6%, respectively. Infection after PFR had an incidence of 7.6% and a reoperation rate of 6.4%. The reoperation rate for aseptic loosening of the implant was 5.9%. Overall, patients had improved outcomes as documented by postoperative hip scores. Conclusion PFR usage have a relatively high complication rate, however, it remains an efficacious treatment option in elderly patients with osteoporotic bone affected by severe proximal femoral bone loss. Modular designs have shown reduced dislocations rate and higher survivorship free from dislocation. However, PFR should only be used as salvage procedure when no other reconstruction options are available.
format	article
author	Fabio Mancino Vincenzo Di Matteo Fabrizio Mocini Giorgio Cacciola Giuseppe Malerba Carlo Perisano Ivan De Martino
author_facet	Fabio Mancino Vincenzo Di Matteo Fabrizio Mocini Giorgio Cacciola Giuseppe Malerba Carlo Perisano Ivan De Martino
author_sort	Fabio Mancino
title	Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
title_short	Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
title_full	Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
title_fullStr	Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
title_full_unstemmed	Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
title_sort	survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c07808b2455647e4920f1d640874e0c7
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Survivorship and clinical outcomes of proximal femoral replacement in non-neoplastic primary and revision total hip arthroplasty: a systematic review

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