DOS 2020

182 · DOS Abstracts Revision Arthroplasty with use of a Total Femur Replacement Nikolaj winther, MArtin Kirkegaard, Ulrik Kragegaard, Kurt Skovgaard, Anders Odgaard, Michael Mørk Petersen Department of Orthopaedic Surgery , Rigshospitalet, Copenhagen, Denmark Background: Increasing numbers of THA and TKA are performed with expand- ing applications in a younger and elderly population. Recurrent complicated aseptic and septic revisions and periprosthetic femoral fractures are growing in numbers resulting in extensive loss of femoral bone stock making it unable to support revision implants. For these complicated cases Total Femur Replacement (TFR) is an alternative to amputation. Purpose / Aim of Study: To assess the functional outcomes and the complica- tion associated with TFR used in revision arthroplasty. Materials and Methods: We retrospectively reviewed 21 non-tumour cas- es that received a TFR for revision surgery: mean age 71 (40-85) years, F/ M=12/10, mean follow-up 51 (12-180 months), mean number of previous revisions 3.8 (1-12), history of periprosthetic infection (n=11). The indications for TFR were severe femoral bone loss because of aseptic loosening (n=8), sep- tic loosening (n=6), periprosthetic fracture (n=6) and osteomyelitis (n=1). Findings / Results: Mean operating time was 271 minutes (133- 600). Mean blood loss was 3417ml (560- 7300). 7 patients had a well-fixed acetabulum component and 14 cases had acetabular cup revision. 8 hips received a con- strained liner, 4 patients a dual mobility cup and 9 cases had non-constraint liners. None of the 8 cases with a constrained liner dislocated, 8 of 13 patients (62%%) without constraint liners dislocated. 11 patients had no additional pro- cedures and 10 patients had additional surgical procedures with 6 patients re- vised for infection: 1 total exchange of the TFR and 5 treated with DAIR. No amputations were performed. 14 patients were on lifelong antibiotics, and at end of follow-up 4 patients had died of causes unrelated to surgery. We found good patient satisfaction and low pain scores with low activity level. Conclusions: TFR for revision surgery in non-tumour cases resulted in limb sal- vage in all patients and with only 1 patient having total exchange of the TFR implant. However, minor revision for infection and hip dislocation was common occurrences. 161.