Addressing the Femoral Side: From Minimal to Severe Bone Loss

Revision of the femoral component in total hip arthroplasty (THA) involves a unique set of challenges that are not encountered in the primary setting. Frequently, the pathology that caused the component to fail also results in remodeling of the bone, or worse, bone loss of varying degrees. Furthermore, the act of implant removal can contribute to further bone and soft tissue damage. These processes can result in a substantially more difficult femoral component replantation. In the face of these challenges, the surgeon must achieve the standard goals of THA, including restoration of leg length, offset, hip stability, and stable fixation of a durable prosthesis. This chapter aims to provide case-based content to guide assessment of the patient’s remaining anatomy and present surgical tips that can allow the treating surgeon to solve this challenge in a reliable fashion.