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Rare Femur Surgery Gives Patient New Lease on Life

A 65-year-old Cedar Grove woman says many folks jokingly refer to her as “the bionic woman.” And for good reason. Mrs. B. underwent a total femur replacement by Dr. Frank Femino to replace the degenerated bone in her leg. This rare orthopedic procedure connected her artificial hip to a carefully crafted 12-inch titanium femur, and then connected that implant to a new artificial knee. It’s a surgery most orthopedic surgeons would balk at because of the high degree of technical expertise required and the enormous risk of surgical complications. But also one that intrigued Dr. Femino. “What made this case particularly challenging was the complexity based on the physical condition of the patient’s bone,” said Dr. Femino. “There were many factors to take into consideration -- soft tissue, blood supply, poor bone quality and the uncertainty of how much bone she was going to lose.” Osteoporosis Patient Mrs. B. has suffered from the brittle-bone disease osteoporosis for the past nine years, fracturing an arm and shoulder, and finally a hip, for which she sought help from Dr. Femino. Dr. Femino performed four surgeries and joint replacement to correct subsequent fractures and degeneration of her left leg and hip. But soon Mrs. Brown was facing the replacement of her femur bone. “Because her bone was so fragile, it did not support her weight anymore,” Dr. Femino said. “She was in terrible pain and using a wheelchair to get around. Although the thought of replacing her entire femur was quite daunting, it was really the only chance she had to improve her diminished quality of life.” Besides being in constant pain, Mrs. B.’s disintegrating bone over time had twisted and shortened her leg, and severe arthritis had worn away her left knee. She was relegated to wearing a shoe with a lift just to help maintain her balance. Custom Implant Dr. Femino worked closely with engineers from Zimmer (a company that manufactures artificial implants) to produce the custom prosthesis, which took approximately three months to perfect, going over the specifications carefully to ensure that that they were exact. During the surgery, Dr. Femino removed all hardware from previous surgeries as well as the disintegrated bone until only the bones around her left hip and knee joint and the artificial hip joint remained. He then coupled a one-piece titanium femur to the hip implant, then with utmost dexterity attached the opposite end to an artificial knee which replaced her severely arthritic one. The result was titanium implants that replaced the bones in her left leg from her hip down to her mid-shin. “What made this surgery so unique is that I coupled a femoral replacement to an existing hip stem,” he explained. “While femur replacements for cancer patients are more common, the coupling of the knee to an artificial hip through a titanium bar that replaces the femur is relatively rare." Life-Changing Event In addition to replacing Mrs. B.’s left femur and knee, Dr. Femino was also able to stretch her leg to its correct length, thus enabling her to walk normally again. “My condition has changed 100 percent,” she enthused. “I am not in any pain, my leg is straight, and I can wear regular shoes now for the first time in a year. This surgery has changed by appearance, my self-esteem, my outlook, and most importantly the way I feel.”