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- Talk
- 23/09/2021
- UK
Free Paper Session: Achieving Distal Fixation and Early Mobilisation In Patients with Severe Femoral Bone Loss Using an Internal Proximal Femoral Replacement Prosthesis
Description
In this presentation, Chi Chi Menakaya discusses advancements in treating patients with severe bone loss through a custom internal proximal femur replacement, highlighting the challenges faced in revision surgery and the clinical applications of the Stanmore implant. With a focus on a case study involving a 77-year-old patient with significant bone loss and multiple surgeries, Menakaya introduces the need for innovative prosthetic solutions to achieve proper distal fixation and weight-bearing capabilities.
The presentation details the types of bone loss categorized by the Paprosky classification, specifically discussing the complexities of treating Paprosky 3b and 4 defects, where substantial metaphyseal loss complicates traditional surgical approaches. Menakaya emphasizes the historical context of the Stanmore implant, which has been in use for over 25 years, while addressing the lack of long-term outcome data and encouraging further research in this area.
Key highlights include the importance of post-operative weight bearing and the use of heated coatings and plasma spraying to promote osteointegration with remaining bone stock. Menakaya reports on a study where 250 custom implants were analyzed, noting significant improvements in both radiological outcomes and Oxford Hip scores, with a particular focus on increased osteointegration and accelerated patient recovery.
The speaker also shares insights into alternative implants and their limitations for patients with poor bone quality and outlines the challenges of cone conical fixation. The conclusion emphasizes the potential benefits of the Stanmore implant in achieving instant fixation, preserving soft tissue for functional mobility, and suggests an earlier consideration of such implants to improve outcomes in frail patients. Finally, Menakaya invites further exploration into patient selection and timing for utilizing these advanced prosthetic options.