Abstract

The purpose of this study was to evaluate the hypothesis that the mechanical failure rate is reduced by the combined use of cortical strut and impacted cancellous allografts. There were 10 men and 14 women in the series, with a mean age at the time of the index revision of 56.6 years (range, 43–69 years). They were followed up for a minimum of 5 years (mean, 5.8 years; range, 5–7 years). The Harris Hip Score improved from a mean of 26 points (range, 10–37 points) before revision surgery to a mean of 83 points (range, 45–100 points) at the latest review. The mean visual analogue scale to pain was 8.4 (4–10), and the mean satisfaction visual analogue scale was 8.7 (4–10). WOMAC scores at the latest review correspond to mild pain, mild stiffness, and only moderate difficulty with physical activity. One femoral stem (4%) had aseptic loosening, and it was revised. Two hips (8%) had infection. All allografts were incorporated to the host femur. The combination of proximal onlay strut grafts with impaction bone grafting in femora with proximal segmental bone defects is associated with very acceptable results at midterm follow-up.

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