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Paprosky Classification of femoral bone loss
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Paprosky Classification of Femoral Bone Loss
Type I - minimal metaphyseal bone loss
Type II - extensive metaphyseal bone loss, minimal diaphyseal bone loss
Type IIIA - extensive metaphyseal and diaphyseal bone loss with greater or equal to 4 cm intact diaphysis for "scratch fit"
Type IIIB - extensive metaphyseal and diaphyseal bone loss with less than 4 cm of intact diaphysis
Type IV - extensive metaphyseal and diaphyseal bone loss with a non-supportive isthmus
Treatments
I - cylindrical fully porous coated stem (consider tapered proximal geometry or cemented stem)
II - diaphyseal engaging stem
IIIA - diaphyseal engaging stem (impaction grafting, modular stems)
IIIB - tapered stem with splines for rotational stability (impaction grafting, modular stems, PFR)
IV - PFR, impaction grafting with cemented stem, allografts
Aribindi, Barba, Solomon, Arp, Paprosky. Bypass fixation. Orthop Clin North AM. 1998;29:319.
Paprosky, Aribindi. Hip Replacement: treatment of femoral bone loss using distal bypass fixation. ICL 2000;49:119-130.
Della Valle, Paprosky. The femur in revision total hip arthroplasty evaluation and classification. CORR 2004;420:55-62.
Cross, Paprosky. Managing femoral bone loss in revision total hip replacement: fluted tapered modular stems. Bone Joint J. 2013;95 (11 supp A):95-97.
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