Total femoral replacement

The development of limb salvage techniques in the operative management of malignant bone tumors has emerged asa result of effective neoadjuvant preoperative chemotherapy. Wide excision of these tumors has replaced radical excision as definitive management. In cases where wide excision requires removal of the entire femur, total femoral replacement is indicated. The reconstructive surgeon may choose from a wide variety of endoprosthetic designs, ranging from complete femoral allografts to entire metallic endoprostheses. The specific femoral prosthesis and surgical approach are individualized to patient clinical characteristics and to tumor anatomy. Despite a high complication rate, total femoral replacement offers the patient limb salvage and a chance at functional ambulation.