A Novel Reconstruction of the Paprosky IV Femoral Defect Using Isthmusoplasty and Tapered Fluted Stem

CASE: A 51-year-old woman diagnosed with periprosthetic joint infection was referred to our hospital for reimplantation. Her femoral bone defect was classified as Paprosky type IV defect, which is challenged to reconstruct due to the lack of isthmus for stem fixation. She underwent isthmusoplasty to enhance the fixation of modular taper fluted titanium (TFT) stem and demonstrated satisfactory 50-month follow-up results in revision total hip arthroplasty (THA). CONCLUSION: The isthmusoplasty technique could be used to enhance the fixation for the modular TFT stem by reconstructing a conical canal in the coronal plane for Paprosky IV femoral bone defect reconstruction in revision THA.