{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:39:33Z","timestamp":1787841573227,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J West Afr Coll Surg"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Total femoral replacement (TFR) is not a common surgery and most indications are for oncological pathologies. However, there are few instances where non-oncological indications might necessitate TFR; this may be a salvage surgery for failed previous hip and\/or knee surgeries with consequent significant femur bone loss. We present a 59-year-old obese woman with right thigh pain and difficulty with walking of 5 years duration. She had undergone bilateral total knee replacement 10 years earlier on account of severe knee osteoarthritis. She had a fall 3 years prior to presentation and sustained a periprosthetic fracture around the right knee which was managed with a fixed angle blade plate and screws. This was complicated by implant breakage and non-union. She subsequently had implant removal and a right distal femur replacement (DFR) surgery 2 years prior to presentation. A year after the DFR surgery, she began to experience \u201cstart-up\u201d pain, instability around the knee and difficulty with walking without support. A clinical and radiologic diagnosis of aseptic loosening of the distal femur megaprosthesis was made and she was offered a revision DFR surgery which also failed due to poor cementing technique, bone loss at the proximal femur, and severe osteoporosis. Patient ended up with a right total femur replacement to salvage the limb. She had improved Lower Extremity Functional Score of 27 after 12-month follow-up. TFR is a viable salvage procedure for severely compromised femur and\/or significant bone loss from multiple non-oncological surgeries of the femur.<\/jats:p>","DOI":"10.4103\/jwas.jwas_244_22","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T06:00:20Z","timestamp":1724133620000},"page":"83-86","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Total Femur Replacement as a Salvage Procedure for Failed Distal Femur Megaprosthesis: A Case Report and Literature Reviews"],"prefix":"10.4103","volume":"15","author":[{"given":"Michael Ebiyon","family":"Ugbeye","sequence":"first","affiliation":[{"name":"Arthroplasty Unit, Orthopaedic and Trauma Department, National Orthopaedic Hospital, Igbobi, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehinde Adesola","family":"Alatishe","sequence":"additional","affiliation":[{"name":"Orthopaedic and Trauma Department, National Orthopaedic Hospital, Igbobi, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wakeel Olaide","family":"Lawal","sequence":"additional","affiliation":[{"name":"Orthopaedic and Trauma Department, National Orthopaedic Hospital, Igbobi, Lagos, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"CIT0001-20241205","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1302\/0301-620X.91B11.21996","article-title":"Total femoral endoprosthetic replacement following excision of bone tumours","volume":"91-B","author":"Sewell","year":"2009","journal-title":"J Bone Joint Surg Br"},{"key":"CIT0002-20241205","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1097\/01.blo.0000142351.88039.e8","article-title":"Total femoral arthroplasty for salvage of end stage prosthetic disease","volume":"427","author":"Berend","year":"2004","journal-title":"Clin Orthop Relat Res"},{"key":"CIT0003-20241205","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.arth.2006.01.007","article-title":"The shattered femur: Radical solution options","volume":"21","author":"Lombardi","year":"2006","journal-title":"J Arthroplasty"},{"key":"CIT0004-20241205","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1186\/s12891-016-1355-6","article-title":"Short-to long-term follow-up of total femoral replacement in non-oncologic patients","volume":"17","author":"Toepfer","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"key":"CIT0005-20241205","doi-asserted-by":"crossref","first-page":"2693","DOI":"10.2106\/00004623-200512000-00013","article-title":"Revision arthroplasty with use of total femur prosthesis","volume":"87","author":"Friesecke","year":"2005","journal-title":"J Bone Joint Surg 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Arthroplasty"},{"key":"CIT0009-20241205","doi-asserted-by":"crossref","first-page":"e789","DOI":"10.3928\/01477447-20140825-55","article-title":"Total femur replacement for salvage of periprosthetic fractures","volume":"37","author":"Clement","year":"2014","journal-title":"Orthopaedics"},{"key":"CIT0010-20241205","first-page":"166","article-title":"Total femur replacement: A case report with 35-year follow-up study","volume":"375","author":"Present","year":"1990","journal-title":"Clin Orthop Relat Res"},{"key":"CIT0011-20241205","doi-asserted-by":"crossref","first-page":"418","DOI":"10.2106\/JBJS.J.00834","article-title":"Failure mode classification for tumor endoprostheses: Retrospective review of five institutions and a literature review","volume":"93","author":"Henderson","year":"2011","journal-title":"J Bone Joint Surg Am"},{"key":"CIT0012-20241205","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1186\/s13018-019-1423-3","article-title":"Establishment and validation of a nomogram model for aseptic loosening after tumor prosthetic replacement around the knee: A retrospective analysis","volume":"14","author":"Zhang","year":"2019","journal-title":"J Orthop Surg Res"},{"key":"CIT0013-20241205","first-page":"44","article-title":"A case report of dual incision technique for total femur arthroplasty as a salvage procedure in infected non-unions","volume":"7","author":"Agrawal","year":"2017","journal-title":"J Orthop Case Rep"},{"key":"CIT0014-20241205","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/00003086-200006000-00027","article-title":"Reconstruction of hip stability after proximal and total femur resections","volume":"375","author":"Bickels","year":"2000","journal-title":"Clin Orthop Relat Res"},{"key":"CIT0015-20241205","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1054\/arth.2003.50037","article-title":"Successful reimplantation of total femoral prosthesis after deep infection","volume":"18","author":"Morimoto","year":"2003","journal-title":"J Arthroplasty"}],"container-title":["Journal of West African College of 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