Femoral fixation in revision total hip arthroplasty.

Management of the femur during revision total hip arthroplasty can be challenging. Strategies for femoral reconstruction are based on understanding the degree of femoral bone loss. Numerous options exist for femoral reconstruction depending on the quantity and quality of the remaining femoral bone stock, including cemented fixation, cementless fixation using proximally porous-coated implants, cylindrical extensively porous-coated implants, modular and nonmodular tapered fluted stems, impaction bone grafting, allograft-prosthetic composites, and proximal femoral replacements (megaprostheses). An understanding of the results of various methods of femoral reconstruction is helpful in guiding the revision surgeon faced with a challenging femoral revision.