Chapters Transcript Video Ortho Oncology - Proximal Femoral Replacement Luke H. Balsamo, M.D., presents a case where he performs a left proximal femoral replacement due to a chondrosarcoma of bone on a 51 year old male. Hello. My name is luke balsamo. I'm an orthopedic oncologist. Work with atlantic orthopedic specialist in Virginia Beach. I'm here today to present a case we did at Centrally Hospital. This is a 51 year old male who presented with left hip pain. The imaging and biopsy was consistent with a contra sarcoma of bone which is a malignancy of the musculoskeletal system. The diagnosis indicates a proximal femoral replacement, which we're gonna go through today on the video patients in the main operating room. In the lateral position. His head is to the right of the screen and his feet are to the left launched. A final decision is made initially. Eclipsing out the biopsy. Track the head is to the right, the feeder to the left and you're seeing the short external dictators and the hip abductor. Here we have cut the capsule and have tagged the edges. You can see the femoral head deep in the wound bed following exposure and measuring of the lesion. A osteo to me is performed at the proximal femur. Once cut, the proximal femur is removed. A narrow margin is sent for confirmation and visual inspection is used to confirm that lesion is confined to the bone. The rejection bed shows the asked again with the residual hip capsule and the hip abductors. Finally the establishes sized and the femur is reamed to accept the cemented prosthesis, which is then symbol on the back table. Once the implant is assembled and the tapers are inspected, cement is placed into the thermal canal and the final implant is cemented in place. It is held in place and tell cement cures. And then he will be taken through a range of motion. Care is taken to remove any extraneous cement address. Um It has cured, the head ball is placed on the trillion and the final bipolar component is assembled. The entire component is reduced into the assad Tagle, um and the leg is taken through a range of motion to confirm stability. As you can see, it is very stable. At this point, the hip capsule and the short extra agitators are tied over the top of the federal neck of the implant. A drain is placed to prevent a hematoma formation and the residual tissues are closed over the top of the implant to ensure no implant is visible. The hip is again taken through a range of motion and it's not to be stable. Published April 29, 2021 Created by Related Presenters Luke H. Balsamo, M.D. Atlantic Orthopaedic Specialists View full profile
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