Volume 467, Number 1, 206-212, DOI: 10.1007/s11999-008-0573-0

Revision of the Deficient Proximal Femur With a Proximal Femoral Allograft

Oleg Safir, Catherine F. Kellett, Michael Flint, David Backstein and Allan E. Gross

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Abstract

Substantial bone loss is frequently encountered with revision hip arthroplasty. A proximal femoral allograft may be used to reconstitute bone stock in the multiply revised femur with segmental bone loss of greater than 5 cm. We retrospectively reviewed 92 patients (93 hips) who underwent such proximal femoral allografts. The average age at the surgery was 61 years. The average number of previous revision procedures was 2.5. Six patients were lost to followup. Thirty-four of 36 deceased patients had the original proximal femoral allograft at the time of death. The minimum followup for the 50 remaining patients was 15 years (average, 16.2 years; range, 15–22 years). Analysis included survivorship and radiographic assessment. Of the 50 patients reviewed, two had a failed reconstruction due to infection, six for aseptic loosening, three for nonunion, and four for dislocation. Revision of the proximal femoral allograft for all reasons excluding the acetabulum was performed in seven patients. At last followup, 42 patients (84%) had a well-functioning construct. Proximal femoral allograft for revision hip arthroplasty in femoral segmental bone loss is a durable alternative in most patients for a complex problem.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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