I've had two hip replacements on one side. The first one got an infection and had to be removed and replaced. The second one started sinking down into the bone. We had to start over again. I've lost a lot of bone with all these surgeries. What can they really do now?

There's no doubt that bone deficiency after failed total hip replacement is a challenge. However, surgeons say there are several choices at this point. The goal is to save the joint and its function.

Two implants available for this problem include the megaprosthesis and the allograft prosthesis composite. Each one is designed for a specific problem. Patients with large portions of bone removed due to bone tumor may be the best candidates.

The third option is to use a custom-made rod-shaped femoral stem that fits into what's left of the femoral bone canal. According to a recent study of 16 patients with a problem like yours, there were 15 patients with excellent results. One patient had some problems after surgery that required another operation.

Reconstruction of joints with severe bone loss is a challenge but it can be done. Your surgeon will advise you based on what's best for you. In some cases, fusion is the final option.

Reference: 

Nicholas Sotereanos, MD, et al. Revision Total Hip Arthroplasty with a Custom Cementless Stem with Distal Cross-Locking Screws. In The Journal of Bone and Joint Surgery. May 2006. Vol. 88-A. No. 5. Pp. 1079-1084.

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