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.