Structural Allograft for Femoral Deficiency in Revision Total Hip Arthroplasty

Abstract

Purpose: We investigated the results and the effectiveness of structural allografts, which were obtained from a donated cadaver for femoral deficiency in revision total hip arthroplasty. Materials and Methods: We reviewed 27 patients who received a structural allograft for femoral deficiency in revision total hip arthroplasty with a minimum follow-up of 2 years. All allografts were fresh frozen bone obtained from donated cadavers. Whole proximal femur was used in 3 patients and strut or cortical onlay graft in the others. The results were evaluated by using Harris hip scores and by the presence of complications, clinically and stability of stem, osteolysis, radiolucent line, and by the radiographic union of the allograft. Results: The average Harris hip score improved from 40.1 preoperatively to 86.9 postoperatively, and the stem showed bony stability in 18 patients, fibrous stability in 8 patients, and instability in 1 patient due to the recurrence of infection. Radiologically, osteolysis was observed in 4 patients (14.8%), radiolucent line over 2 mm in 1 patient, and union of allografts in 25 patients (92.6%) that showed stable stem. The average union time was 7.5 months. Nonunion of allografts were observed in 2 patients revised with a cancellous bone autograft. Complications were infection in 1 patient, dislocation in 2 patients, and heterotopic ossi fication in 1 patient. Conclusion: Structural allografts obtained from cadaveric donor were used for large femoral deficiency in revision total hip arthroplasty. Our results show that satisfactory union and can successfully restore the bone stock for further surgery.