This narrative review by Parvizi and Sim examines the indications, surgical technique, and outcomes of proximal femoral megaprosthesis reconstruction for non-neoplastic conditions — including failed THA, proximal femoral nonunion, and failed resection arthroplasty — asking when this salvage option is appropriate and what results surgeons should expect.
When facing massive proximal femoral bone loss in an elderly or sedentary patient where allograft-prosthetic composite or biologic reconstruction is not feasible, megaprosthesis is a viable salvage — but counsel patients on a ~22% dislocation risk, plan for constrained liners in roughly half, and know that survivorship drops to 64% by 12 years, making this a poor choice in younger or active patients.
This narrative review by Parvizi and Sim examines the indications, surgical technique, and outcomes of proximal femoral megaprosthesis reconstruction for non-neoplastic conditions — including failed THA, proximal femoral nonunion, and failed resection arthroplasty — asking when this salvage option is appropriate and what results surgeons should expect.
When facing massive proximal femoral bone loss in an elderly or sedentary patient where allograft-prosthetic composite or biologic reconstruction is not feasible, megaprosthesis is a viable salvage — but counsel patients on a ~22% dislocation risk, plan for constrained liners in roughly half, and know that survivorship drops to 64% by 12 years, making this a poor choice in younger or active patients.