Total Femur Prosthetic Replacement

It is a procedure that involves removing a tumor (usually malignant or benign aggressive) of the thigh bone (femur) and in most instances replacing the entire bone with a special customizable total femur tumor prosthesis.

Total Femur Xr2

What is a Total Femur Prosthetic Replacement?

The femur is the long bone of your thigh and is important for proper function of the hip and knee joints. The entire femur is a relatively common site for primary sarcomas and metastatic disease. Some of these tumors include osteosarcoma, chondrosarcoma, and Ewing’s sarcoma. The common muscles of your femur (thigh bone) include your hamstrings and quadriceps. A total femur prosthetic replacement involves a radical resection of the femur containing the sarcoma and replacing the bone with a prosthesis. A total femur prosthetic replacement is considered a limb-sparing surgery. Limb-sparing surgery can be performed for approximately 95% of tumors arising from the upper femur. Adjuvant (additional) therapies, such as chemotherapy and/or radiation, may be used in conjunction with this procedure as treatment for various bone sarcomas. In some instances, the extremity cannot be saved and an amputation is performed.

Contraindications for saving the limb may include neurovascular invasion, infection, pathological fracture, invasion of the pelvis, extensive disease, contamination from a poorly performed biopsy, recurrent disease.

What’s involved in the technique?

What you can expect afterwards

After your surgery you will spend a few nights in the hospital and then will be recuperating at home. Various pain protocols and nerve blocks are used to minimize pain. Mostly all patients are very comfortable after the surgery. For the first few days you will ice the area and keep it elevated to reduce swelling. You will return to the office 2 weeks after surgery. Patients are usually kept in a hip abductor brace for 6 weeks to allow the muscles to heal and prevent dislocation of the hip by stabilizing the prosthesis. Once cleared, you will subsequently start physical therapy. We usually prescribe specific physical therapy protocols 3 times a week for 12 weeks after surgery to gradually strengthen muscles. Strengthening with significant resistance after sufficient range of motion is achieved as determined by Dr. Wittig. There may be an ultimate weight limit imposed upon you depending on various factors.  

You will be monitored periodically with X-ray and MRI imaging over the course of 5 years to ensure there are no signs of recurrence. You will have follow up appointments every 4 months for the first 2 years, then every 6 months for the next 2 years, and then once a year. Since the integrity of the limb has been restored to full or almost full, recovery is anticipated provided the patient adheres to strict physical therapy.

Types Of Physical Therapy

Total Femur Prosthetic Replacement Video

Dr. James Wittig narrates a video illustrating the surgical technique for resection of the total femur (thigh bone) and reconstruction of the hip and knee joint utilizing a total femur tumor prosthesis. | WATCH VIDEO