Extreme Ectasia of the Femoral Diaphysis Secondary to Loosening of a Long Wagner Stem

We report an unusual case of a patient with a total hip replacement who had extreme femoral expansion around a loose Wagner revision stem. The technical requirements of revision surgery for the treatment of femoral ectasia depend largely on the magnitude of the bone loss. Treatment options include resection arthroplasty1,2, cortical strut allografting3,4, impaction allografting5-8, an allograft-prosthesis composite9-13, or the use of a custom-made pros-thesis14-16. In this particular patient, the degree of expansion presented a unique obstacle to proximal bone reconstruction. The purpose of this report was to describe our technique of volume reduction with primary distal femoral fixation. We believe that this technique preserves native bone and attempts to restore proximal femoral anatomy. Our patient was informed that data concerning her case would be submitted for publication.