This narrative review addresses the full decision-making framework for femoral component revision after THA — from diagnostic workup and failure classification to component extraction techniques and fixation strategy selection — with the Paprosky classification as its organizing scaffold.
When planning femoral component revision, classify the proximal femoral defect with Paprosky before choosing implant type: type I–IIIA gets an extensively porous-coated stem, type IIIB gets a modular tapered fluted stem, and type IV requires allograft prosthetic composite or proximal femoral replacement — and always have extended trochanteric osteotomy planned and instrumented for any well-fixed stem removal.
This narrative review addresses the full decision-making framework for femoral component revision after THA — from diagnostic workup and failure classification to component extraction techniques and fixation strategy selection — with the Paprosky classification as its organizing scaffold.
When planning femoral component revision, classify the proximal femoral defect with Paprosky before choosing implant type: type I–IIIA gets an extensively porous-coated stem, type IIIB gets a modular tapered fluted stem, and type IV requires allograft prosthetic composite or proximal femoral replacement — and always have extended trochanteric osteotomy planned and instrumented for any well-fixed stem removal.