Abstract
Introduction: The increasing utilization of total hip arthroplasty and the increasing life expectancy have brought an increasing incidence of revision hip arthroplasty. With severe acetabular, revision surgery with the use of standard cemented or press-fitted components is inadequate for fixation. In these cases the use of proximal femoral allograft can restore the deficiency.
Purpose: To present a new technique and preliminary results of revision total hip arthroplasty using proximal femoral allograft prosthetic composites for massive ace-tabular bone loss. The technique uses the natural vector of forces in the intertrochanteric region in an opposite direction at the acetabular defect.
Methods: From June 2000 to July 2001, seven patients underwent reconstruction of massive acetabular defects with proximal femoral allograft bone. The etiologies for bone loss were infection in 2 patients, aseptic loosening in 4 and acetabular protrusion in 2 patients. In 4 hips there were also femoral defects that was reconstructed with allograft. The average age of the patients was 69.8 years. All patients were wheel chair bound prior to surgery. Harris Hip Score was used to assess preoperative and follow-up function level.
Results: Harris Hip Score improved significantly in all patients. All patients are ambulatory at follow-up. Complications included 2 dislocation and 2 deep-vein thrombosis. No allograft resorbtion was noted at follow-up.
Conclusions: The proximal femoral allograft provides a solid construct for the acetabular cup in large acetabular bone defects. Although failure and complication rates might be higher than revision procedures with lesser bone defects, this reconstructive option for massive ace-tabular defects dramatically improves a patient’s function level.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
