Abstract
Aim: Proximal femoral allografts are a rare but valuable option in severe femoral bone loss in revision hip arthroplasty. However, there are no long-term follow-up reports on their use. The purpose of this study was to review the average 11-year results of massive proximal femoral allografts used for severe bone loss in revision hip arthroplasty.
Method: Sixty-three total hip arthroplasties in 60 consecutive patients were revised with a proximal femoral allograft and a prosthesis. The mean length of the allograft was fifteen centimeters. All patients had undergone at least one previous total hip arthroplasty, with a mean of 3.8 operations. Each patient was assessed before operation and at follow-up with a modified Harris hip score and radiographs.
Results: At a mean follow-up of 11 years (range: nine to 15 years), 45 patients (75%) were alive, 14 patients (23 %) were deceased and one patient was lost to follow- up. The average preoperative Harris hip score was 30 points; at the latest follow-up the average score of those with the original graft in situ was 71. The deceased and lost patients represented 15 allografts (24%) with an average of five years and seven months follow-up. There were five failures for infection, four of which were successfully revised. Three hips failed with aseptic loosening at average 10 years and three months, two have been successfully re-revised and the third is awaiting revision. Success was defined as a postoperative increase in the Harris hip score of greater than twenty points, a stable implant, and no need for further surgery related to the allograft at the time of review. The success rate for all patients was 78% at an average of nine years follow-up. The success rate of those living was 77% at an average of 11 years follow-up.
Conclusion: At an average of 11-years following proximal femoral allografts the clinical and radiological results were encouraging.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
