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Case Reports
. 2023 Jan 18:19:101089.
doi: 10.1016/j.artd.2022.101089. eCollection 2023 Feb.

A Custom Device to Couple Proximal and Distal Femoral Stems: A Case Report and Literature Review

Arturo Corces  1 , John Heifner  2 , Gabriel Zavurov  3
Affiliations
Case Reports

A Custom Device to Couple Proximal and Distal Femoral Stems: A Case Report and Literature Review

Arturo Corces et al. Arthroplast Today. .

Abstract

Complex periprosthetic fractures may occur with existing ipsilateral hip and knee implants. These cases are challenging with few options. We report on a custom coupler used to connect a hinged distal femoral replacement to an existing revision hip stem. This option was preferred to a total replacement of the femur. The custom coupler maintained the anatomic attachments of the proximal femur, preserved abductor strength during ambulation, and mitigated the morbidity which may arise from a total femur replacement. At 15 months postoperatively, the patient reported no pain, did not demonstrate an antalgic gait pattern, and had satisfactory range of motion at the hip and knee. The literature displays clinical and biomechanical efficacy for coupling devices although complications and device failure are quite variable.

Keywords: connector; coupler; distal femur replacement; femoral sleeve; periprosthetic fracture.

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Figures

Figure 1
Figure 1
Anteroposterior radiograph of bilateral femurs with left-sided periprosthetic fracture of the distal femur.
Figure 2
Figure 2
Osteotomy (a) and removal (b) of the distal femur nonunion.
Figure 3
Figure 3
The custom coupler (a) was cemented into the proximal femur stem and fixed into the distal femur replacement (b and c).
Figure 4
Figure 4
Postoperative anteroposterior radiographs of the pelvis (a), left knee (b), and left hip (c) with a custom device coupling the existent proximal femur stem into the distal femur replacement.
See this image and copyright information in PMC

References

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