Circumferential proximal femoral allografts in revision hip arthroplasty: four to 20 years follow-up

Purpose: The purpose of this study was to analyze the clinical and radiographic results of revision of loose total hip replacements, using proximal femoral allografts and a cemented implant. Material and methods: We retrospectively reviewed of 28 consecutive patients. Twenty patients were available for study. Each patient was scored using a modified Harris Hip Score. Radiographs were examined for endosteal and periosteal reabsorption, allograft-host union, trochanteric migration, component loosening and heterotrophic calcification. Results: The mean pre-operative Harris hip Score was 34 points. At the latest follow-up, the mean-score was 80 points. Nineteen cases (95%) had combined femoral defects and one patient (5%) had a segmental defect, according to the AAOS classification. Allograft resorption was seen in eight (40%) hips. There were 18 cases (90%) of allograft union, one (5%) of partial union and one (5%) of nonunion. There was one case of trochanteric migration (more than 1 cm). All femoral components were radio-graphically stable. The reconstruction was considered successful in 18 patients (90%). Conclusion: The use of proximal femoral allografts in femoral revision of loose total hip replacements has high survival and satisfactory clinical results at an average period of eight years postoperatively.