Total hip sytem/radiograph interpretation

Looks like an intramedullary total femur. I would guess this patient had a prior infected total hip that required extensive debridement, and this was implanted after. I will talk to our rep to see if he recognizes the exact type.

Seems to be a Howmedica proximal femoral replacement. Dall Miles cables suggest that there are strut grafts on the prosthesis or were used to secure the bone. Confusing thing to me is that proximal femoral replacement usually needs a constrained liner which I don't see. In either case I wish them the best of luck.

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This is a revision femoral stem. It is a modular, uncemented, tapered stem. It is not a proximal femoral replacement or a total femur. Looks like a Stryker product, probably Restoration T3. Another company with similar design, but fluted tapered and HA coated, is the Link stem. The modular design enables good diaphyseal fit for revision, possibly for a loose primary hip. Probaly not revised for infection as the cup looks like the primary cup. The Dahl Miles cables are likely closing down an extended trochanteric osteotomy approach used to remove the prior stem. I do not see any strut grafts. If the hip is stable, no constrained liner is indicated. Probably new poly insert and original cup. The modular design enables restoration of leg length and stability while ensuring a good tapered fit in the remaining femoral bone.

Hope this helps.


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Thanks alot for all your help, it is much appreciated.

Yep, a modular system it is. It may be a total femur, but without distal xrays who knows, or it could be just a proximal lfemoral replacement. We often dissect the entire femur out, splitting the proximal femur longitudinallyfor about 12-20 inches leaving the soft tissue attachments. The remaining femur comes out. In the open femur (split open like a pipe) lies the implant, and the cortical shell is then wrapped around the proximal portion of the implant and secured with Cables. This seems to add to some stability, as with resection of the entire femur and replacement, there are no muscular attachments to assist with control. Fun cases!

It is NOT a total femur or PFR. Those all have a bunch of holes proximally to try and attach soft tissues through. 99% this is a stryker modular restoration (or very close ripoff).