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Femoral Bone Loss Classification
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Chapter Synopsis
This chapter reviews classification systems for femoral bone loss in total hip arthroplasty.
Important Points
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Preoperative radiographic evaluation of bone loss helps to evaluate intraoperative findings.
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Extended trochanteric osteotomy should be used with little hesitation if needed to aid in implant extraction and safe, accurate femoral preparation.
Clinical/Surgical Pearls
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Appropriate treatment of femoral bone loss can be determined by intraoperative classification.
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Needed instrumentation and structural bone grafts should be determined preoperatively.
Clinical/Surgical Pitfalls
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Lack of adequate knowledge of bone loss may lead to insufficient preparation of structural allografts and instrumentation.
Introduction
Revision total hip arthroplasty (THA) can often be difficult and requires significant preoperative planning before the procedure. Availability of the appropriate hip instrumentation, implants, and bone grafts requires knowledge of the amount of bone loss on both sides of the hip joint. This chapter reviews the preoperative and intraoperative classification of femoral bone loss associated with revision THA.
Indication and Contraindications
All patients undergoing revision THA should have preoperative planning with evaluation of bone loss. The lack of adequate prostheses and storage of allografts in most hospitals necessitates evaluation of femoral bone stock before operative treatment.
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