Proximal femoral replacement.

Reconstruction of the proximal femur after extensive bone loss is clinically challenging. Options for reconstruction depend on the classification and extent of the proximal femoral defect. Although reconstitution of the native proximal femoral bone stock are the traditional goals of most revision techniques for the proximal femur, these techniques lose their effectiveness after numerous revisions due to the severe loss of a sufficient amount of structural bone needed to reconstruct the femur and abductor attachment. Consequently, the proximal femoral bone becomes fragile with extensive bone loss despite bone grafting. Techniques that use allograft-prosthetic composite and femoral megaprosthesis can successfully restore a patient's ambulatory ability despite the absence of significant portions of the proximal femur.