Table 2.

Different surgical techniques described for massive femoral spacer.

Author	Material used	Hip articulation	Knee articulation	Disadvantage
Richards et al. [9]	Kuntscher nail with an Exeter stem	Cemented Exeter hip arthroplasty (polyethylene liner + stem). No proximal implant coating	Fixed with Kuntscher nail	-Free metal -Price -Knee fusion -No offset variation
Sherman et al. [10]	Unipolar trial long stem femoral component	Unipolar polar head coated with antibiotic PMMA	NO. Cemented implant in a minimal distal femoral bone	-Price -Distal fixation inadequate -No offset variation
Cassar Gheiti et al. [11]	Femoral intramedullary nail with a CPCS stem	Unipolar head. No proximal implant coating	Fixed with femoral intramedullary nail	-Free metal -Price -Knee fusion -No offset variation
Kamath et al. [4]	Femoral intramedullary nail with PROSTALAC spacer	PROSTALAC spacer. Partial proximal implant coating	Fixed with femoral intramedullary nail modified	-Free metal (less that previous) -Price (++) -Knee fusion -No offset variation -Metal-cutting burr needed -Less antibiotic in the PMMA
Current paper	Trochanteric long nail with 2 Rush pins	Handmade hemiarthroplasty (over cephalic screw). All implant is coated with antibiotic PMMA	Handmade ball and socket articulation (over Rush pins)	-Technical demanding (first cases)

PMMA, poly methyl methacrylate.