The Wagner Modular (S2) Prosthesis for Proximal Femur Bone Loss ; Prospective Study of 19 Cases

Background: Wagner proximal femur prosthesis is the versatile modular implant. Study Design: Prospective study Setting: Department of Orthopaedic Surgery Dow University of Health Sciences / Civil Hospital Karachi, from January 2013 to December 2019. Methodology: Total 19 patients of both genders with proximal femur bone loss due to tumor, implant failure for proximal femur fixation, comminuted intertrochanteric fracture, and failed arthroplasty included in the study. After taking written informed consent, detailed demographics including age, gender, indication of wagner prosthesis, and wagner stem type were recorded. Among all the patients 11 patients received total hip replacement and 8 patients received bipolar. Complications associated with procedure were recorded. Outcomes were assessed by Merle D Aubgine scale. Results: Total 19 patients were included in the study who were operated with wagner prosthesis for proximal femur bone deficit problems. 7 (37%) patients were male and 12 (67%) were female , between age of 16 to 70. 13 (68%) patient have proximal femur problem on right side and 6(32%) patient on left side .10 Patient have proximal femur fixation problems and 9 with proximal femur tumor. Modular wagner prosthesis used in all patients . Per-operative one (5%) patient have perforation of cortex and One (5%)patient posterior hip dislocation on next day . Two (11%) patient had per-operative fracture . Maximum follow-up is from 6.3 years to minimum 6 months. One patient with metastasis died within four weeks of surgery. Outcome measured with modified Merle D Aubgine scale showed no excellent, good in 15(79%) , fair 3 (16%), poor 1(5%). Conclusion: Wagner proximal femur modular implant is a versatile implant for proximal femur fixation failure and after proximal femur resection in tumor patients. It is modular with variable options to make stable hip joint. It is cheap as comparative to proximal femur replacement implant for tumor.