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Use of an Interlocking Hydroxyapatite-Coated Stem in a Patient with an Infected Nonunion of a Periprosthetic Femoral Fracture with Massive Bone LossA Case Report
S. Paul Trikha, MRCS1; Sameer Singh, FRCS2; Oliver Raynham, MBChB1; James C. Lewis, MSc, FRCS(Tr and Orth)1; A. John Edge, FRCS1
1 Department of Orthopaedics, Worthing and Southlands Hospitals NHS Trust, Worthing Hospital, Lyndhurst Road, Worthing, West Sussex BN11 2DH, United Kingdom
2 Department of Orthopaedics, Epsom General Hospital, Dorking Road, Epsom, Surrey KT18 7EG, United Kingdom
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 Worthing and Southlands Hospitals NHS Trust, West Sussex, United Kingdom

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Aug 01;86(8):1783-1786
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Revision of a loose femoral stem of a total hip prosthesis in the presence of massive bone loss and previous infection represents a challenging surgical reconstruction. Current reconstructive options include the use of a long prosthetic stem with cemented fixation into a proximal structural allograft, the use of a custom reconstructive tumor endoprosthesis, or strut allograft augmentation of the femur with use of a long cementless femoral stem. Previous infection is a relative contraindication for the use of allograft1,2, and allografts are associated with the complications of fracture and nonunion3. In the present report, we describe an alternative management option for this complex femoral reconstruction that includes the use of a long-stemmed hydroxyapatitecoated implant with distal interlocking screw fixation. Our patient was informed that data concerning the case would be submitted for publication.
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