THE USE OF ALLOGRFT-PROSTHESIS COMPOSITE FOR EXTENSIVE PROXIMAL FEMORAL BONE DEFICIENCIES

Abstract

Extensive bone deficiencies in proximal femur remains a significant challenge in hip surgery. In such a situation, one alternative is to use a proximal femoral allograft-prosthesis composite (APC) to restore the mechanical integrity and bone stock. The current study was performed to analyze the results of APC in the treatment of femoral bone deficiency.

From January 1996 to June 2006, 12 patients who received 15 APC (3 of them received repeated APC), were followed for a mean of 4.2 years (range 2.0 to 9.8 years) by one surgeon. 5 were males and 7 were females and the mean age of the patients was 60.9 years (range 32 to 84 years). 6 patients were diagnosed with septic loosening, 5 were with aseptic loosening, 4 were with re-revision arthroplasty, and 1 was with limb salvage procedure due to malignancy and all were treated with fresh-frozen allograft. The surgical technique was used to cement the femoral component into the allograft but not into the host bone except 1 case.

The average Harris hip score improved from 21.8, preoperatively, to 83.2, the latest follow-up, and the all stems showed good stability except 3 cases of aseptic loosening. These 3 cases went through a repeated operation with another APC after mean 83.7 months (51,92,108 months) and their results showed good stability. 11 APC had a good junctional union. One case was showed junctional nonunion that needed onlay graft at 3.3 years after APC. There were no infections (or septic loosening), dislocations and allogragt fractures (except one great trochanter avulsion fracture, neither clinical symptoms nor went a surgical treatment).

This study demonstrated that the use of APC for extensive proximal femoral bone deficiencies showed a clinically, functionally and radiologically good results. Therefore it is considered as a good options.