Evidence map›Paper›PMID 40074982›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Total femur replacement in revision arthroplasty for non-oncologic patients: a systematic review.

Christopher M Liu, Cooper B Ehlers, Garrett K Berger, Scott T Ball, Frank E Chiarappa

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Christopher M LiuDepartment of Orthopaedic Surgery, University of California San Diego, 4150 Regents Park Row, La Jolla, CA, 92037, USA. liucm3@vcu.edu.ORCID http://orcid.org/0000-0003-4775-462X
Cooper B EhlersDepartment of Orthopaedic Surgery, University of California San Diego, 4150 Regents Park Row, La Jolla, CA, 92037, USA.ORCID http://orcid.org/0000-0001-8623-2897
Garrett K BergerDepartment of Orthopaedic Surgery, University of California San Diego, 4150 Regents Park Row, La Jolla, CA, 92037, USA.ORCID http://orcid.org/0000-0001-8389-0691
Scott T BallDepartment of Orthopaedic Surgery, University of California San Diego, 4150 Regents Park Row, La Jolla, CA, 92037, USA.ORCID http://orcid.org/0000-0002-1879-7703
Frank E ChiarappaDepartment of Orthopaedic Surgery, University of California San Diego, 4150 Regents Park Row, La Jolla, CA, 92037, USA.ORCID http://orcid.org/0000-0003-3832-8629

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRevision total joint arthroplasty cases including those complex enough to require limb-salvage procedures are expected to significantly increase. Total femoral replacements represent a limb-preserving procedure with potential utility for these complicated cases. This review seeks to summarize the outcomes of total femoral replacements when used in the revision arthroplasty setting.

methodsA systematic review was performed by searching Embase, Ovid MEDLINE, PubMed, Wiley Cochrane Library: Central Register of Controlled Trials, and Thompson Reuters Web of Science: Citation Index on February 8, 2024 for studies describing any outcomes and complications of total femur replacements performed for revision arthroplasty. Functional outcomes and postoperative complications were subsequently summarized. This study was registered with PROSPERO (CRD42024509031). Risk of bias assessment was performed using the Methodological Index for Nonrandomized Studies.

resultsEleven of 4817 initially screened studies were included. Indications for total femur replacement largely consisted of periprosthetic infection, periprosthetic fracture, hardware loosening, or a combination thereof. Articles described variable benefit in function, pain, and ambulatory ability. Patients had improved hip and knee function, reduced pain levels, and preserved independent ambulatory ability, though patients largely still required assistive devices. Benefits were limited by the high risk of postoperative complications, especially infection and dislocation.

conclusionTotal femur replacement is an option for limb-salvage surgery in complex revision arthroplasty cases but has high complication rates, particularly infection and dislocation. Advancements aimed at minimizing these complication rates including silver- and iodine-coated implants will be critical in establishing the viability of total femur replacements in this setting.

Indexed as

Arthroplasty, Replacement, HipFemurReoperationHumansPeriprosthetic FracturesPostoperative ComplicationsProsthesis FailureProsthesis-Related InfectionsLimb salvageMegaprosthesisRevision arthroplastyTotal femur replacement

Identifiers

PMID40074982

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.