28 June, 2022

Femoroplasty, a pioneering innovation to settle problems with a hip-prosthetic

Hospital Clínic is a pioneer in Spain in the use of femoroplasty, an innovative technique in which sanitary cement is injected around the hip-prosthetic, inside the femur, to recover stability and so achieve an improvement in pain and recover the patient’s mobility. Dr. Jenaro Fernández-Valencia, head of the Hip Section of the Orthopaedic and Traumatology Surgery Service at Hospital Clínic de Barcelona and professional at barnaclínic+, is one of the people in charge of the design of the protocol and introduction of this technique.

Dr. Fernández-Valencia has as well been the manager of the evolutive control of the first two interventions in which femoroplasty has been executed, one of those carried out in June 2021 and the other in March 2022 with great results in both cases. The femoroplasty in both cases was carried out by a team that featured, among others, Dr. Jordi Blasco, of the Radiology Service at Hospital Clínic and professional at barnaclínic+ and the anaesthesiologists Dr. Jaume Fontanals and Dr. Isabel Belda.

PAINFUL HIP-PROSTHETIC, A DIFFICULT PROBLEM TO SOLVE

Hip-prosthetics are a common resource for ageing patients who look to recover mobility and functionality with the aim of improving quality of life. It’s a safe procedure and one with a high degree of success, but one that is not without any complications. One of which is when the hip-prosthetic loosens and causes pain, making a replacement necessary. But this option isn’t always possible.

In some cases the advanced age of the patient or chronic and grave illness which may warn us off the intervention. Until now, these patients had no other option than to live with this chronic pain, which painkillers didn’t do much to alleviate, and watch their ability to walk become very limited. This complication has now been overcome thanks to femoroplasty. 

Femoroplasty offers a solution to advanced-age patients who, with an unstable hip-prosthetic that causes pain, cannot get a replacement

FEMOROPLASTY, AN INNOVATIVE TECHNIQUE, ECONOMICAL AND MINIMALLY INVASIVE

Femoroplasty is a technique that started to be experimented on in the early 2000s, it’s an economic and minimally invasive procedure that has been tested by other medical teams in Europe. It’s done under sedation, injecting sanitary cement (PMMA) mixed with antibiotics around the hip-prosthetic. In order to achieve this a thin tube is guided in using video images, this is inserted through the front side of the muscle and penetrates the femoral cortical.

Femoroplasty is a much less complex intervention than a traditional prosthetic replacement surgery, which is especially suitable for those patients that, for their fragility, are advised to take the latter and which until now were unable to solve their problem of the loss of stability of the prosthetic. If no complication arises, the patient can be discharged within 24 hours of the procedure. The two patients that have already been operated on with this innovative technique have shown an excellent tolerance and a notable improvement in their pain and the functional limitation that incapicitated them. With an increasingly ageing population that will need more prosthetic replacements, this technique can be the answer for many patients that now don’t have good options.

POSSIBILITY OF WIDENING USE

Despite this technique being suitable for patients with hip-prosthetics, other patients in a similar situation with loose prosthetics or implants in other places (knee, shoulder, etc.), can also benefit greatly from this technique of refastening with cement, as stated by the authors of the 23rd Journal of the Spanish Society of Musculo-Skeletal Radiology, carried out in Coruña from the 25th to the 28th of May this year.