Capsular replacement with synthetic mesh - Effectiveness in preventing postoperative dislocation after wide resection of proximal femoral tumors and prosthetic reconstruction

We describe a surgical technique for replacing the hip joint capsule using synthetic mesh after oncological resections of the proximal femur that resu lted in gross intraoperative instability of the prosthetic reconstruction. The results of its use in 13 patients, 6 of whom also had pelvic resections , are described. These patients were selected from a total group of 88 pati ents undergoing proximal femoral replacement, 75 of whom did not require ca psular replacement (none of these 75 patients have experienced dislocation) . In the group requiring capsular reconstruction, 1 of 4 patients with bipo lar hemiarthroplasty and 4 of 9 patients with total hip replacements experi enced dislocation after operation. Of the dislocated total hip replacements , 1 remains chronically dislocated, and 3 were successfully stabilized by o pen reduction with further capsular augmentation. Given that the resections involved removal of most of the soft tissues stabilizing the hip joint, we believe that the technique of capsular reconstruction is useful in this di fficult group of patients.