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Extreme Ectasia of the Femoral Diaphysis Secondary to Loosening of a Long Wagner StemA CASE REPORT
Morteza Kalhor, MD1; Hubert P. Nötzli, MD2; Michael D. Stover, MD3; Reinhold Ganz, MD4
1 Iran University of Medical Sciences, Firouzgar Medical Center, Tehran 15934, Iran
2 Department of Orthopaedic Surgery, University of Zurich, Balgrist Clinic, CH-8008 Zurich, Switzerland
3 Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL 60153
4 Department of Orthopaedic Surgery, University of Bern, Inselspital, CH-3010 Bern, Switzerland. E-mail address: reinhold.ganz@insel.ch
View Disclosures and Other Information
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at Inselspital, Bern, Switzerland

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Mar 01;86(3):590-594
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We report an unusual case of a patient with a total hip replacement who had extreme femoral expansion around a loose Wagner revision stem. The technical requirements of revision surgery for the treatment of femoral ectasia depend largely on the magnitude of the bone loss. Treatment options include resection arthroplasty1,2, cortical strut allografting3,4, impaction allografting5-8, an allograft-prosthesis composite9-13, or the use of a custom-made pros-thesis14-16. In this particular patient, the degree of expansion presented a unique obstacle to proximal bone reconstruction. The purpose of this report was to describe our technique of volume reduction with primary distal femoral fixation. We believe that this technique preserves native bone and attempts to restore proximal femoral anatomy. Our patient was informed that data concerning her case would be submitted for publication.
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