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📔Check out 'THE KNEE BOOK - A GUIDE TO THE AGING KNEE' - https://amzn.to/4ipudoP ➡️ My latest book - 'O.R. Confidential: Confessions of a Gen X Surgeon' - https://amzn.to/407Ae1R Check out other video lectures - • Orthopedic Education For Surgeons 👍 Give it a LIKE 💎Follow me on Facebook - / dradamrosen Paprosky Classification of Femoral Bone Loss Type I - minimal metaphyseal bone loss Type II - extensive metaphyseal bone loss, minimal diaphyseal bone loss Type IIIA - extensive metaphyseal and diaphyseal bone loss with greater or equal to 4 cm intact diaphysis for "scratch fit" Type IIIB - extensive metaphyseal and diaphyseal bone loss with less than 4 cm of intact diaphysis Type IV - extensive metaphyseal and diaphyseal bone loss with a non-supportive isthmus Treatments I - cylindrical fully porous coated stem (consider tapered proximal geometry or cemented stem) II - diaphyseal engaging stem IIIA - diaphyseal engaging stem (impaction grafting, modular stems) IIIB - tapered stem with splines for rotational stability (impaction grafting, modular stems, PFR) IV - PFR, impaction grafting with cemented stem, allografts Aribindi, Barba, Solomon, Arp, Paprosky. Bypass fixation. Orthop Clin North AM. 1998;29:319. Paprosky, Aribindi. Hip Replacement: treatment of femoral bone loss using distal bypass fixation. ICL 2000;49:119-130. Della Valle, Paprosky. The femur in revision total hip arthroplasty evaluation and classification. CORR 2004;420:55-62. Cross, Paprosky. Managing femoral bone loss in revision total hip replacement: fluted tapered modular stems. Bone Joint J. 2013;95 (11 supp A):95-97. Support the show (https://www.patreon/TotalKneeTips)